Comparative effectiveness of intraarticular injection of PRP and implantation of heparin-conjugated fibrin hydrogel in osteoarthrosis of the knee joint

Aim of the study. The article is devoted to the current trend of modern orthopedics – the surgical treatment of local full-thickness defects in the hyaline cartilage of the knee joint. This pathology is diagnosed in 5-10% of patients with diseases and injuries of the knee joint.
Materials and methods. The authors of the article presented one of the most modern and available technologies for the restoration of cartilage defects – the implantation of Heparin-Conjugated Fibrin Hydrogel. This operation technique was used in 38 patients. The article presents the indications and technique of surgery, criteria for evaluating treatment outcomes.
Results and discussion. Treatment outcomes in terms of up to 2 years were studied in 38 patients. Good treatment results were observed in 33 patients. In all cases, high-quality and regeneration of the cartilaginous surface of the femoral condyles was achieved.
Conclusion. Analysis of the outcomes of treatment of patients after implantation implantation of Heparin- Conjugated Fibrin Hydrogel allows the authors of the article to recommend this technique for widespread use in clinical practice.

1. Adult stem cells in bone and cartilage tissue engineering /A. J. Salgado, J. T. Oliveira, A. J. Pedro, R. L. Reis //Curr. Stem. Cell. Res. Ther. – 2006. – V. 1 (3). – P. 345-364.

2. Bozhokin M. S. Possibilities of modern cellular technologies for the restoration of damaged articular cartilage (analytical review of the literature) /M. S. Bozhokin, S. A. Bozhkova, G. I. Netylko // Traumatology and Orthopedics of Russia. – 2016. – V. 3. – P. 122-134.

3. Canine mesenchymal stem cells from synovium have a higher chondrogenic potential than those from infrapatellar fat pad, adipose tissue, and bone marrow /A. Sasaki, M. Mizuno, N. Ozeki et al. // PLoS One. – 2018. – V. 13 (8). – e0202922.

4. Cartilage engineering: a crucial combination of cells, biomaterials and biofactors /C. Vinatier, D. Mrugala, C. Jorgensen et al. //Trends Biotechnol. – 2009. – V. 27 (5). – P. 307-314.

5. Chimutengwende-Gordon M. Current solutions for the treatment of chronic articular cartilage defects in the knee /M. Chimutengwende-Gordon, J. Donaldson, G. Bentley //EFORT Open Rev. – 2020. – V. 5 (3). – P. 156-163.

6. Combinations of Hydrogels and Mesenchymal Stromal Cells (MSCs) for Cartilage Tissue Engineering-A Review of the Literature /M. Wagenbrenner, S. Mayer-Wagner, M. Rudert //Gels. – 2021. – V. 7 (4). – P. 217.

7. Ding D. C. Mesenchymal stem cells /D. C. Ding, W. C. Shyu, S. Z. Lin //Cell Transplant. – 2011. – V. 20 (1). – P. 5-14.

8. Garkavi A. V. Arthroscopic chondroplasty of local cartilaginous defects of the knee joint using the chondro-gide collagen membrane /A. V. Garkavi, M. Yu. Blokov //Traumatology and Orthopedics. – 2015. – V. 3 (15). – P. 4-7.

9. Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017 /S. Safiri, A. A. Kolahi, E. Smith et al. //Ann. Rheum. Dis. – 2020. – V. 79 (6). – P. 819-828.

10. Heparin-Conjugated Fibrin Hydrogel with Chondroinductive Growth Factors and Human Synovium-Derived Mesenchymal Stem Cells for the Treatment of Articular Cartilage Defects: Evaluation of Clinical Safety /T. A. Toktarov, B. N. Saginov, Y. K. Raimagambetov //International Journal of Biomedicine. – 2022. – V. 12 (4). – P. 539-547.

11. Hiligsmann M. The economic weight of osteoarthritis in Europe /M. Hiligsmann, J. Y. Reginster //J. Medicographia. – 2013. – V. 35. – P. 197-202.

12. Hoffman J. K. Articular cartilage repair using marrow stimulation augmented with a viable chondral allograft: 9-month postoperative histological evaluation /J. K. Hoffman, S. Geraghty, N. M. Protzman //Case Rep. Orthop. – 2015. – V. 2015. – 617365.

13. Huang B. J.Cell-based tissue engineering strategies used in the clinical repair of articular cartilage /B. J. Huang, J. C. Hu, K. A. Athanasiou // Biomaterials. - 2016. – V. 98. – P. 1-22.

14. Huselstein C. Mesenchymal stem cells for cartilage engineering /C. Huselstein, Y. Li, X. He // Biomed. Mater. Eng. – 2012. – V. 22 (1-3). – P. 69-80.

15. Jones B. A. Synovium-derived stem cells: a tissuespecific stem cell for cartilage engineering and regeneration /B. A. Jones, M. Pei //Tissue Eng. Part. B. Rev. – 2012. – V. 18 (4). – P. 301-311.

16. Knee articular cartilage repair and restoration techniques: a review of the literature /D. L. Richter, R. C. Schenck Jr, D. C. Wascher, G. Treme //Sports Health. – 2016. – V. 8 (2). – P. 153-160.

17. Koga H. Synovial stem cells are regionally specified according to local microenvironments after implantation for cartilage regeneration /H. Koga, T. Muneta, Y. J. Ju //Stem Cells. – 2007. – V. 25 (3). – P. 689-696.

18. Kushner F. D. Knee Surgery /F. D. Kushner, V. N. Scott, J. R. Scuderi – Moscow: Medical Literature, 2014. – 274 p.

19. Mesenchymal stem cell implantation in osteoarthritic knees: is fibrin glue effective as a scaffold? /Y. S. Kim, Y. J. Choi, D. S. Suh et al. //Am. J. Sports. Med. – 2015. – V. 43 (1). – P. 176-185.

20. Mesenchymal stem cell therapy to rebuild cartilage /D. Magne, C. Vinatier, M. Julien et al. // Trends Mol. Med. – 2005. – V. 11 (11). – P. 519-526.

21. Outcome of autologous matrix induced chondrogenesis (AMIC) in cartilage knee surgery: data of the AMIC Registry /J. Gille, P. Behrens, P. Volpi, et al. //Arch. Orthop. Trauma Surg. – 2013. – V. 133 (1). – P. 87-93.

22. Patent of the Republic of Kazakhstan. A method for obtaining an injectable biocomposite hydrogel to stimulate the regeneration of bone and cartilage tissue /V. B. Ogay, A. S. Isabekova, M. A. Sarsenova, E. M. Ramankulov. 2019; 33784: 29.

23. Ridley T. J. Patellofemoral articulating osteochondral (Kissing) lesion treated with autologous chondrocyte implantation: a case report /T. J. Ridley, C. T. Rud, J. A. Macalena //J. Orthop. Case. Rep. – 2017. – V. 7 (3). – P. 41-44.

24. Scaffold-based repair for cartilage healing: a systematic review and technical note /G. Filardo, E. Kon, A. Roffi, A. Di Martino et al. //Arthroscopy. – 2013. – V. 29 (1). – P. 174-186.

25. Synoviumderived mesenchymal stem cells: a new cell source for musculoskeletal regeneration /J. Fan, R. R. Varshney, L. Ren et al. //Tissue Eng. Part. B. Rev. – 2009. – V. 15 (1). – P. 75-86.

26. The Clinical Use of Human Culture-Expanded Autologous Bone Marrow Mesenchymal Stem Cells Transplanted on Platelet-Rich Fibrin Glue in the Treatment of Articular Cartilage Defects: A Pilot Study and Preliminary Results /A. M. Haleem, A. A. Singergy, D. Sabry et al. //Cartilage. – 2010. – V. 1 (4). – P. 253-261.

27. The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years /A. Klug, Y. Gramlich, M. Rudert et al. //Knee Surg. Sports Traumatol. Arthrosc. – 2021. – V. 29 (10). – P. 3287-3298.