The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration

Abstract Introduction Microfracture does not lead to complete healing of full-thickness cartilage defects. The aim of this study was to evaluate the effect of modifying Wnt/β-catenin signaling following microfracture, on the restoration of a full-thickness cartilage defect in a rabbit model. The mod...

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Main Authors: Nikitas P. Schizas, Olga Savvidou, Kalliopi Diamantopoulou, Stamatios Papadakis, Panayiotis J. Papagelopoulos, Ioannis K. Triantafyllopoulos
Format: Article
Language:English
Published: BMC 2019-12-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-019-1484-3
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author Nikitas P. Schizas
Olga Savvidou
Kalliopi Diamantopoulou
Stamatios Papadakis
Panayiotis J. Papagelopoulos
Ioannis K. Triantafyllopoulos
author_facet Nikitas P. Schizas
Olga Savvidou
Kalliopi Diamantopoulou
Stamatios Papadakis
Panayiotis J. Papagelopoulos
Ioannis K. Triantafyllopoulos
author_sort Nikitas P. Schizas
collection DOAJ
description Abstract Introduction Microfracture does not lead to complete healing of full-thickness cartilage defects. The aim of this study was to evaluate the effect of modifying Wnt/β-catenin signaling following microfracture, on the restoration of a full-thickness cartilage defect in a rabbit model. The modification of the canonical Wnt pathway was achieved through per os administration of lithium carbonate, which is an intracellular inhibitor of glycogen synthase kinase 3-β (Gsk3-β) and therefore induces Wnt/β-catenin signaling. Materials and methods Full-thickness cartilage defects of 4 mm in diameter were created in the patellar groove of the right femurs of 18 male New Zealand white rabbits. The rabbits were divided into three groups of six (n = 6) based on post-surgery treatment differences, as follows: microfracture only (group 1), microfracture plus lithium carbonate 7 mM in the drinking water for 1 week (group 2), microfracture plus lithium carbonate 7 mM in the drinking water for 4 weeks (group 3). All animals were sacrificed 9 weeks after surgery. The outcome was assessed histologically, by using the International Cartilage Repair Society (ICRS) visual histological scale. Immunohistochemistry for type II collagen was also conducted. Results Statistical analysis of the histological ICRS scores showed that group 3 was significantly superior to group 1 in four out of six ICRS categories, while group 2 was superior to 1 in only two out of six. Conclusion The combination of microfracture and systematic administration of lithium carbonate 7 mM for 4 weeks shows statistically significant superiority in four out of six ICRS categories compared with microfracture only for the treatment of full-thickness cartilage defects in a rabbit experimental model.
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spelling doaj.art-bda89305a8cd4af8b10233b37c99d2272022-12-22T04:03:57ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-12-011411710.1186/s13018-019-1484-3The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regenerationNikitas P. Schizas0Olga Savvidou1Kalliopi Diamantopoulou2Stamatios Papadakis3Panayiotis J. Papagelopoulos4Ioannis K. Triantafyllopoulos5Laboratory for the Research of Musculoskeletal System, Medical School, National and Kapodistrian University of AthensFirst Department of Orthopaedics, Athens University Medical School, National and Kapodistrian University of Athens, School of MedicinePathology Department, KAT Hospital Kifissia2nd Department of Orthopaedic Surgery, KAT Hospital KifissiaFirst Department of Orthopaedics, Athens University Medical School, National and Kapodistrian University of Athens, School of MedicineLaboratory for the Research of Musculoskeletal System, Medical School, National and Kapodistrian University of AthensAbstract Introduction Microfracture does not lead to complete healing of full-thickness cartilage defects. The aim of this study was to evaluate the effect of modifying Wnt/β-catenin signaling following microfracture, on the restoration of a full-thickness cartilage defect in a rabbit model. The modification of the canonical Wnt pathway was achieved through per os administration of lithium carbonate, which is an intracellular inhibitor of glycogen synthase kinase 3-β (Gsk3-β) and therefore induces Wnt/β-catenin signaling. Materials and methods Full-thickness cartilage defects of 4 mm in diameter were created in the patellar groove of the right femurs of 18 male New Zealand white rabbits. The rabbits were divided into three groups of six (n = 6) based on post-surgery treatment differences, as follows: microfracture only (group 1), microfracture plus lithium carbonate 7 mM in the drinking water for 1 week (group 2), microfracture plus lithium carbonate 7 mM in the drinking water for 4 weeks (group 3). All animals were sacrificed 9 weeks after surgery. The outcome was assessed histologically, by using the International Cartilage Repair Society (ICRS) visual histological scale. Immunohistochemistry for type II collagen was also conducted. Results Statistical analysis of the histological ICRS scores showed that group 3 was significantly superior to group 1 in four out of six ICRS categories, while group 2 was superior to 1 in only two out of six. Conclusion The combination of microfracture and systematic administration of lithium carbonate 7 mM for 4 weeks shows statistically significant superiority in four out of six ICRS categories compared with microfracture only for the treatment of full-thickness cartilage defects in a rabbit experimental model.https://doi.org/10.1186/s13018-019-1484-3MicrofractureCartilage repairFibrocartilageWnt/β-catenin pathwayLithium carbonate
spellingShingle Nikitas P. Schizas
Olga Savvidou
Kalliopi Diamantopoulou
Stamatios Papadakis
Panayiotis J. Papagelopoulos
Ioannis K. Triantafyllopoulos
The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration
Journal of Orthopaedic Surgery and Research
Microfracture
Cartilage repair
Fibrocartilage
Wnt/β-catenin pathway
Lithium carbonate
title The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration
title_full The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration
title_fullStr The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration
title_full_unstemmed The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration
title_short The combination of microfracture with induction of Wnt / β- Catenin pathway, leads to enhanced cartilage regeneration
title_sort combination of microfracture with induction of wnt β catenin pathway leads to enhanced cartilage regeneration
topic Microfracture
Cartilage repair
Fibrocartilage
Wnt/β-catenin pathway
Lithium carbonate
url https://doi.org/10.1186/s13018-019-1484-3
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