{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:38:04Z","timestamp":1787715484216,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the efficacy of mesenchymal stem cell (MSC) exosomes with hyaluronic acid (HA) against HA alone for functional cartilage regeneration in a rabbit osteochondral defect model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Critical\u2010size osteochondral defects (4.5\u2010mm diameter and 1.5\u2010mm depth) were created on the trochlear grooves in the knees of 18 rabbits and were randomly allocated to 2 treatment groups: (1) exosomes and HA combination and (2) HA alone. Three 1\u2010mL injections of either exosomes and HA or HA alone were administered intra\u2010articularly immediately after surgery and thereafter at 7 and 14 days after surgery. At 6 and 12 weeks, gross evaluation, histologic and immunohistochemical analysis, and scoring were performed. The functional biomechanical competence of the repaired cartilage also was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared\u00a0with defects treated with HA, defects treated with exosomes and HA showed significant improvements in macroscopic scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .032;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .001) and histologic scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .005;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) at 6 and 12 weeks, respectively. Defects treated with exosomes and HA also demonstrated improvements in mechanical properties compared with HA\u2010treated defects, with significantly greater Young\u2019s moduli (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) and stiffness (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) at 6 and 12 weeks. By 12 weeks, the newly\u2010repaired tissues in defects treated with exosomes and HA composed mainly of hyaline cartilage that are mechanically and structurally superior to that of HA\u2010treated defects and demonstrated mechanical properties that approximated that of adjacent native cartilage (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05). In contrast, HA\u2010treated defects showed some repair at 6 weeks, but this was not sustained, as evidenced by significant deterioration of histologic scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .002) and a plateau in mechanical properties from 6 to 12 weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study shows that the combination of MSC exosomes and HA administered at a clinically acceptable frequency of 3 intra\u2010articular injections can promote sustained and functional cartilage repair in a rabbit post\u2010traumatic cartilage defect model, when compared with HA alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Human MSC exosomes and HA administered in combination promote functional cartilage repair and may represent a promising cell\u2010free therapy for cartilage repair in patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2020.03.031","type":"journal-article","created":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T19:37:37Z","timestamp":1586893057000},"page":"2215","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":88,"title":["Intra\u2010Articular Injections of Mesenchymal Stem Cell Exosomes and Hyaluronic Acid Improve Structural and Mechanical Properties of Repaired Cartilage in a Rabbit Model"],"prefix":"10.1002","volume":"36","author":[{"given":"Keng Lin","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Sengkang General Hospital Singhealth"},{"name":"Departments of Orthopaedic Surgery 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Science Technology and Research Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai Kiang","family":"Lim","sequence":"additional","affiliation":[{"name":"Surgery Yong Loo Lin School of Medicine Singapore"},{"name":"National University of Singapore; and Institute of Medical Biology Agency for Science Technology and Research Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng Hin","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery Singapore"},{"name":"Tissue Engineering Program Life Sciences Institute Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Hoi Po","family":"Hui","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery Singapore"},{"name":"Tissue Engineering Program Life Sciences Institute Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei 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