Development of a novel surgical procedure for large osteochondral defects using platelet rich plasma(PRP)

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The purpose of this study was to develop a new surgical technique for intra-articular osteochondral defects using porous hydroxyapatite (HA) including platelet rich plasma (PRP)-derived fibrin gel and scaffold-free cartilage tissue produced by the alginate-recovered-chondrocyte method (ARC method). First of all, we examined the effects of PRP-derived fibrin gel on the metabolism of cultured rabbit chondrocytes. The maturation process of the ARC tissue on porous HA block in vivo was also investigated. On the basis of these results, we implanted HA blocks with PRP (or platelet poor plasma, PPP) and the ARC tissue into the large osteochondral defects, and examined the effects of this procedure on bone and cartilage tissue repair. Three-dimensional cultivation of articular chondrocytes (embedded in alginate beads) on PRP-derived fibrin gel promoted their proliferation and total proteoglycan (PG) content in alginate bead, while PG content normalized with DNA content in alginate bead was significantly decreased by PRP gel When the ARC tissue was placed on porous HA block and implanted into subcutaneous pocket of athyrnir nude mice, the tissue was well integrated with the surface of Hablock. Maturation of the ARC tissue was observed in this condition within 8 weeks. Implantation of the HA-ARC tissue constructs with PRP gel into osteochondral defects enhanced cartilage repair and bone formation. These results suggest that combination of PRP gel with HA-ARC implantation can be a useful procedure for the repair of large osteochondral lesions.