Growth Hormones are essential for bone remodeling, cartilage repair, and sustaining lean muscle mass in both children and adults. Although the effect of growth factors in bone remodeling and muscle development is well-documented, their role in cartilage repair is poorly understood. It is assumed that growth factors play crucial roles in the growth and proliferation of cartilage but its mechanisms of cartilage repair are still under research.
Defects in the chondrocytes are primarily responsible for the early onset of osteoarthritis. Treatment protocols for early osteoarthritis have not been clearly established and different modalities are used throughout the medical community with extensive debates regarding their efficacy. Therefore, treatment of chondrocyte damage-induced arthritis is a major challenge to healthcare specialists worldwide. One of the suggested modalities of treatment includes the use of growth factors to accelerate the healing of damaged cartilages and revert or slow the disease progression.
Research On The Role Of Growth Factors
Multiple studies have presented widely variable reports on the efficacy of growth factors in cartilage repair. Using keywords such as cartilage repair or chondrocyte in association with growth factor, a PubMed search was conducted to identify and research documents on previous studies on the role of growth factors on cartilage repair. This search revealed studies that used combination therapy of growth hormone in the form of platelet-derived growth factor, fibroblast growth factor, Bone morphogenetic protein, transforming growth factors, and bone marrow concentrate.
The most commonly used forms were BMC and PRP which are both generated by centrifugation. The ease of extraction of these growth factors is the reason for their frequent use. In horse models with severe cartilage damage, BMC and PRP were both found to result in improvement in cartilage repair. The improvement was found to be sustained in both short-term and long-term inspection of the cartilage. The most significant difference was observed in the integration of the repaired tissue around the healthy cartilage as the BMC and PRP treated cartilage had a much smoother and thicker surface integration.
The implication of The Findings
Examination of the effects of growth hormones in terms of both their catabolic and anabolic metabolism has demonstrated benefits in in-vitro as well as in animal model studies for extensively damaged cartilage repair. Other factors such as TGF, IGF-1, and PDGF have also been shown to have potential as adjuncts in growth factor therapy.
The studies conducted using growth factors in the form of BMC and PRP reported significant improvement in the structure and biochemical composition of the regenerated cartilage matrix. The ease of extraction and route of administration via needles for both BMC and PRP makes them the first choice as growth factors for cartilage repair. Most researchers have focused on either PRP or BMC but there are very limited studies on the combined effect of these therapies.
As of now, the research results indicate growth factor therapy to be a promising modality in the treatment of extensive cartilage damage but larger-scale studies need to be conducted that examine the efficacy of both the isolated and combined use of growth factors in a long-term study.
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