Intraosseous adipose mesenchymal stem cells and plasma rich in growth factors: A promising approach for articular cartilage and subchondral bone regeneration

Intra-articular (IA) infiltration of plasma rich in growth factors (PRGF) and adipose-derived mesenchymal stem cells (ASCs) have been proposed as a potential treatment for patients with osteoarthritis, due to their regenerative properties and ability to promote cartilage healing. However, in patients with severe osteoarthritis, where not only cartilage but also the subchondral bone is affected, IA infiltration of these regenerative therapies appears to be less effective. To overcome this limitation, intraosseous (IO) infiltration of PRGF and ASCs has recently been proposed. The objective of this study was to evaluate the effectiveness of IO infiltration with PRGF, ASCs, and their combination (PRGF+ASCs) in treating acute full-thickness chondral lesions in a rabbit model. Forty healthy rabbits were allocated into four groups based on the IO treatment administered (control, PRGF, ASCs, or PRGF+ASCs). A full-thickness chondral defect was created in the medial femoral condyle, followed by IO treatment infiltration. Additionally, all rabbits, regardless of group, received an IA infiltration of PRGF. At 56- and 84-days post-infiltration, the groups treated with any of the three regenerative therapies showed improved histological outcomes compared to the control group, with the PRGF+ASCs group demonstrating the most significant cartilage healing. The results suggest that IO infiltration of PRGF, ASCs, or their combination enhances the regeneration of articular cartilage and subchondral bone and provides more sustained effects compared to IA infiltration of PRGF alone.