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TRANSLATIONAL AND CLINICAL RESEARCH

Injectable Mesenchymal Stem Cell Therapy for Large Cartilage Defects—A Porcine Model

The Department of Orthopaedic Surgery, National University of Singapore, and the Department of Experimental Surgery, Singapore General Hospital, Singapore, Republic of Singapore

Key Words. Cartilage defects • Minimally invasive • Mesenchymal stem cells • Hyaluronic acid • Injectable

Correspondence: James H.P. Hui, M.B.B.S., Department of Orthopaedic Surgery, National University of Singapore, Lower Kent Ridge Road, Singapore 119074, Republic of Singapore. Telephone: +65-67724331; Fax: +65-67780720; e-mail: jameshui{at}nus.edu.sg

Received May 24, 2006; accepted for publication June 18, 2007.
First published online in STEM CELLS EXPRESS   July 26, 2007.



Current techniques in biological resurfacing of cartilage defects require an open arthrotomy or arthroscopy and involve the direct transplantation of isolated cells and/or scaffolds or whole tissue grafts with chondrogenic potential onto the cartilage defect. Our study investigates the possibility of direct intra-articular injection of mesenchymal stem cells suspended in hyaluronic acid (HA) as an alternative to the much more invasive methods currently available. A partial-thickness (without penetration of the subchondral bone) cartilage defect was created in the medial femoral condyle of an adult minipig. Mesenchymal stem cells from the iliac crest marrow of the same pig harvested in a separate procedure and suspended in 2 milliliters of hylan G-F 20 (Synvisc) were injected intra-articularly after the creation of the defect. This was followed by two more injections of hylan G-F 20 (HA) at weekly intervals. Either saline or HA was injected into the knees of the controls. The pigs were sacrificed at 6 and 12 weeks for morphological and histological analysis. The cell-treated groups showed improved cartilage healing both histologically and morphologically at 6 and 12 weeks compared with both controls. The use of intra-articular injections of mesenchymal stem cells suspended in HA is a viable option for treating large cartilage defects. This would be further explored in clinical trials.

Disclosure of potential conflicts of interest is found at the end of this article.