Can the Use of Adjuvants Enhance the Efficacy of the Micro-fracture Treatment for Managing Focal Chondral Defects? An Experimental Study in a Rat Model

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Abstract Background: To evaluate whether there are any differences in the efficacies of microfracture (MF) surgeries used in the treatment of focal cartilage lesions alone or in combination with adjuvant therapies.Methods: 42 rats were included in the study. Group 1 received MF alone, Group 2 received platelet rich plasma (PRP) after MF, Group 3 received hyaluronic acid (HÁ) after MF, Group 4 received a synthetic peptide (SP) after MF, Group 5 received a SP plus PRP therapy after MF, and Group 6 received a SP plus HA therapy. Group 7 was designated as the control group. The rats knees were evaluated with the International Cartilage Repair Society Cartilage Repair Assessment 1 and 2 (ICRS-1 and ICRS-2).Results: The ICRS-1 scores were lower in Group 1 than in Group 2, Group 3, Group 4, and Group 7 (p < 0.05). The ICRS-1 scores were higher in Group 7 than in Group 5 and Group 6 (p < 0.05). The ICRS-2 scores in Group 7 were similar to those in Group 2, Group 3, and Group 4 (p < 0.05), the scores were found to below in Group 1, Group 5, and Group 6 (p < 0.05). The inflammation scores were lower in Group 3 than in Group 2 and Group 4 (p < 0.05).Conclusion: In the MF treatment of focal chondral lesions, SP, PRP, and HA injections have a beneficial adjuvant effect based on macroscopic and histopathological findings. However, the combination of these adjuvants is less beneficial than their individual usage

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