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The Effect of Intraarticular Insulin on Chondral Defect Repair.
CARTILAGE ( IF 2.8 ) Pub Date : 2020-07-02 , DOI: 10.1177/1947603520938462
Eren Yildiz 1 , Ali Ersen 2 , Emre Yener 3 , Nil Comunoglu 4 , Cengiz Sen 2
Affiliation  

Objective

The aim of this study is to evaluate the effects of intraarticular insulin on the treatment of chondral defects.

Design

Twenty-four mature New Zealand rabbits were randomly divided into 3 groups as control (Group 1), microfracture (Group 2), and microfracture and insulin (Group 3). Four-millimeter full-thickness cartilage defects were created to the weight-bearing surface on the medial femoral condyles of each rabbit. In the first group, any additional interventions were not performed. Microfracture was performed on defects in groups 2 and 3. Additionally, 10 IU of insulin glargine was administrated into the knee joints of the third group. Three months after surgery, the knee joints were harvested and cartilage quality was assessed according to Wakitani and ICRS (International Cartilage Repair Society) scores histopathologically. Insulin injections were performed into the knees of 2 additional rabbits without creating a cartilage defect to evaluate the potential adverse effects of insulin on healthy cartilage (Group 4).

Results

The total ICRS and Wakitani scores of the insulin group were found to be significantly lower than the microfracture group but similar to the control group. No negative effects of insulin on healthy cartilage were detected. Intraarticular insulin after surgery has led to a statistically significant decrease in systemic blood sugar levels whereas the decrease observed after administration to intact tissues was not statistically significant.

Conclusions

Insulin had a negative influence on the quality of cartilage regeneration and had no effect on healthy cartilage. Intraarticular insulin administration does not cause significant systemic effects in intact tissue.



中文翻译:

关节内胰岛素对软骨缺损修复的作用。

客观的

本研究的目的是评估关节内注射胰岛素对软骨缺损治疗的效果。

设计

24只成年新西兰兔随机分为3组:对照组(第1组)、微骨折组(第2组)、微骨折加胰岛素组(第3组)。在每只兔子的股骨内侧髁的承重表面上制造四毫米全层软骨缺损。在第一组中,没有进行任何额外的干预。对第2组和第3组的缺损进行微骨折。此外,将10 IU甘精胰岛素注射到第三组的膝关节中。术后三个月,采集膝关节,并根据 Wakitani 和 ICRS(国际软骨修复协会)组织病理学评分评估软骨质量。对另外 2 只兔子的膝盖进行胰岛素注射,但没有造成软骨缺损,以评估胰岛素对健康软骨(第 4 组)的潜在不利影响。

结果

发现胰岛素组的总 ICRS 和 Wakitani 评分显着低于微骨折组,但与对照组相似。没有检测到胰岛素对健康软骨的负面影响。手术后关节内注射胰岛素导致全身血糖水平出现统计学显着下降,而对完整组织给药后观察到的下降则没有统计学意义。

结论

胰岛素对软骨再生质量有负面影响,对健康软骨没有影响。关节内注射胰岛素不会对完整组织造成显着的全身效应。

更新日期:2020-07-02
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