Bilge Kağan Yılmaz1, Mehmet Nuri Konya2, Sinan İnce3, Hasan Hüseyin Demirel3, Yüksel Çetin4, Ayşen Güngör5

1Department of Orthopedics and Traumatology, Afyonkarahisar State Hospital, Afyonkarahisar, Türkiye
2Department of Orthopedics and Traumatology, Afyonkarahisar Health Science University, Afyonkarahisar, Türkiye
3Afyon Kocatepe University Veterinary Faculty Bayat Vocational School, Afyonkarahisar, Türkiye
4Tübitak Marmara Research Center, Life Sciences, Kocaeli, Türkiye
5Department of Stem Cell and Tissue Engineering, Istinye University, Institute of Health Sciences, Istanbul, Türkiye

Keywords: Boric acid, cartilage regeneration, dose dependent, epidermal growth factor, in vitro, in vivo.


Objectives: In this study, we aimed to determine the bioefficacy of epidermal growth factor (EGF), boric acid (BA), and their combination on cartilage injury in rats.

Materials and methods: In in vitro setting, the cytotoxic effects of BA, EGF, and their combinations using mouse fibroblast cell (L929), human bone osteosarcoma cell (Saos-2), and human adipose derived mesenchymal stem cells (hAD-MSCs) were determined by applying MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] test. In in vivo setting, 72 rats were randomly divided into four groups. A standard chondral defect was created and microfracture was performed in all groups. Group A was determined as the control group. In addition to the standard procedure, Group B received 100 ng/mL of EGF, Group C received a combination of 100 ng/mL of EGF and 10 µg/mL of BA combination, and Group D 20 µg/mL of BA.

Results: The cytotoxic effect of the combinations of EGF dilutions (1, 5, 10, 25, 50, 100, 200 ng/mL) with BA (100, 300, 500 µg/mL) was observed only in the 72-h application period and in Saos-2. The cytotoxic effect of BA was reduced when combined with EGF. There was no significant difference in the histopathological scores among the groups (p=0.13).

Conclusion: Our study showed that EGF and low-dose BA application had a positive effect on cartilage healing in rats. Significant decreases in recovery scores were observed in the other groups. The combination of EGF and BA promoted osteoblast growth. Detection of lytic lesions in the group treated with 20 µg/mL of BA indicates that BA may have a cytotoxic effect.

Citation: Yılmaz BK, Konya MN, İnce S, Demirel HH, Çetin Y, Güngör A. Investigation of the efficacy of epidermal growth factor, boric acid and their combination in cartilage injury in rats: An experimental study. Jt Dis Relat Surg 2024;35(1):156-168. doi: 10.52312/jdrs.2023.1074.

Ethics Committee Approval

The study protocol was approved by the Afyon Kocatepe University Animal Experiments Local Ethics Committee (AKUHADYEK) Ethics Committee (date: 01.04.2020, no: 49533702/252. The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept, control/supervision, critical review: B.K.Y., M.N.K.; Design, data collection and/or processing: B.K.Y.; Analysis and/or interpretation: H.H.D., S.İ.; Lıterature review: B.K.Y., Y.Ç., A.G.; Writing the article: B.K.Y., Y.Ç.; References and fundings: M.N.K., Y.Ç., A.G.; Materials: B.K.Y., S.İ., H.H.D.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.