Autologous Platelet-Rich Plasma–Enriched Chondral Matrix Implantation Improves Cartilage Repair in an Ovine Model: A Magnetic Resonance Assessment Using the MOCART 2.0 Scoring System

Background: Articular cartilage defects exhibit a limited intrinsic regenerative capacity and continue to represent a significant challenge in sports medicine, frequently progressing to degenerative joint disease if left untreated. Purpose: To assess cartilage repair after autologous chondral platelet-rich plasma matrix implantation (PACI) in an ovine model using magnetic resonance imaging (MRI) and the MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 scoring system. Study Design: Controlled laboratory study. Methods: Full-thickness chondral defects (8 mm in diameter) were surgically induced in the medial femoral condyles of both stifles in 7 skeletally mature Merino sheep (n = 14 stifles). Right stifles were treated with PACI combined with intra-articular plasma rich in growth factors (PRGF), whereas left stifles received a single intra-articular injection of either Ringer lactate or hyaluronic acid. MRI evaluation was performed 18 months postoperatively to assess cartilage repair using the MOCART 2.0 knee scoring system. Results: PACI-treated stifles demonstrated significantly higher MOCART scores compared with both control groups. Enhanced defect filling, improved integration with adjacent cartilage, and superior repair tissue architecture were observed in the PACI group. Furthermore, PACI-treated stifles exhibited signal intensity values more closely resembling native cartilage, fewer subchondral alterations, and a significantly higher overall MOCART score. Conclusion: PACI combined with PRGF resulted in superior structural cartilage repair compared with control treatments in an ovine model, as assessed by MRI. These findings support its potential clinical applicability for the management of focal cartilage defects in active patients. Clinical Relevance: This laboratory study demonstrates that PACI combined with PRGF improves structural cartilage repair in a clinically relevant ovine model. These findings support the potential use of this regenerative approach for the treatment of focal articular cartilage defects in active patients.