Intra-Articular Purified Exosome Product and Hyaluronan Attenuate Osteoarthritis Progression in a Minimally Invasive Turkey Model

Our study aimed to develop a novel, reproducible, minimally invasive turkey knee osteoarthritis (OA) model and evaluate whether intra-articular hyaluronan (HA) alone or combined with purified exosome product (PEP) attenuates OA-related functional and structural deterioration. OA was induced arthroscopically by transection of the anterior and posterior cruciate ligaments with resection of the anterior horn of the medial meniscus. Animals received intra-articular injections of saline, HA, or PEP + HA at postoperative 2-5 weeks. Gait was assessed at 4, 8, and 12 weeks, and cartilage degeneration, subchondral bone sclerosis, osteophyte formation, synovial fibrosis, heterotopic ossification, and meniscal integrity were evaluated by quantitative CT and histology at week 12. Compared with saline, HA improved lameness, preserved cartilage glycosaminoglycan content, and reduced meniscal rupture, subchondral bone sclerosis, and periarticular heterotopic ossification. PEP + HA provided additional benefits, including prolonged stance phase, reduced synovial fibrosis, and greater chondroprotection than HA alone, while plantar pressure variables, subchondral bone remodeling, and patellar osteophytes did not differ between HA and PEP + HA. This turkey model reliably produces human-like OA changes and enables longitudinal functional and structural assessment. Intra-articular HA mitigated OA progression, and the addition of PEP conferred incremental joint protection.