Institute of Bone and Joint Surgery

Osteoarthritis (OA) is a degenerative disease which disrupts collagenous matrix of articular cartilage, and is difficult to cure because articular cartilage is a nonvascular tissue. Treatment of OA has targeted macromolecular substitutes for cartilage components, such as hyaluronic acid or genetically engineered materials. However, the goal of this study is to examine whether intra-articular injection of the elementary nutrients restores the matrix of arthritic knee joints of mature animals. A nutritive mixture solution (NMS) was composed of elementary nutrients such as glucose or dextrose, amino acids and ascorbic acid. It was administered five times, at the 6th, 8th, 10th, 13th, and 16th weeks, into the unilateral anterior cruciate ligament transected (ACLT) knee joints of mature New Zealand White rabbits. It was compared to normal saline (NS)-injection effect. OA progression was histopathologically evaluated by hematoxylin & eosin (H&E) staining, by the Mankin grading method, and by scanning electron microscopy (SEM) at the 19th week. NMS-injection decreased progressive erosion of articular cartilage overall compared to NS-injection (p<0.01), and showed no differences compared to normal cartilage which did not undergo ACLT, by Mankin grading method. H&E staining and SEM results also showed that NMS-injection, as apposed to NS-injection, restored the cartilage matrix that is known to be composed of a collagen and proteoglycan (PG) network. Thus, NMS-injection is a potent treatment that significantly retards OA progression, which in turn prevents progressive destruction of joints and functional loss in mature animals.