Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
Br J Sports Med. 2009 Apr;43(4):293-8. doi: 10.1136/bjsm.2008.056457. Epub 2009 Feb 17.
To culture collagen-producing cells derived from skin fibroblasts and o evaluate prospectively the safety and potential use of this cell preparation for treatment of refractory lateral epicondylitis in a pilot study.
Prospective clinical pilot study.
Institution-based clinical research.
A total of 12 patients (5 men and 7 women; mean age 39.1 years) with clinical diagnosis of refractory lateral epicondylitis.
Laboratory-prepared collagen-producing cells derived from dermal fibroblasts were injected into the sites of intrasubstance tears and fibrillar discontinuity of the common extensor origin under ultrasonography guidance.
The outcome assessment was performed over 6 months. The Patient-Rated Tennis Elbow Evaluation (PRTEE) scale was used to assess pain severity and functional disability. Tendon healing response was measured using four criteria on ultrasonography: tendon thickness, hypoechogenicity, intrasubstance tears and neovascularity.
Cell cultures rich in collagen-producing cells was successfully prepared. After injection, the median PRTEE score decreased from 78 before the procedure to 47 at 6 weeks, 35 at 3 months and 12 at 6 months after the procedure (p<0.05). The healing response on ultrasonography showed median decrease in: (1) number of tears, from 5 to 2; (2) number of new vessels, from 3 to 1; and (3) tendon thickness, from 4.35 to 4.2 (p<0.05). Of the 12 patients, 11 had a satisfactory outcome, and only one patient proceeded to surgery after failure of treatment at the end of 3 months.
Skin-derived tenocyte-like cells can be cultured in the laboratory to yield a rich preparation of collagen-producing cells. Our pilot study suggests that these collagen-producing cells can be injected safely into patients and may have therapeutic value in patients with refractory lateral epicondylitis.
从皮肤成纤维细胞中培养产生胶原蛋白的细胞，并前瞻性评估该细胞制剂用于治疗难治性外侧肱骨上髁炎的安全性和潜在用途。
前瞻性临床试点研究。
机构内临床研究。
共 12 名患者（5 男 7 女；平均年龄 39.1 岁），临床诊断为难治性外侧肱骨上髁炎。
在超声引导下，将实验室制备的源自真皮成纤维细胞的产生胶原蛋白的细胞注射到共同伸肌起始部的实质内撕裂和纤维状不连续处。
在 6 个月时进行结果评估。使用患者网球肘评估量表（PRTEE）评估疼痛严重程度和功能障碍。超声测量肌腱愈合反应采用 4 项标准：肌腱厚度、低回声、实质内撕裂和新生血管。
成功制备富含产生胶原蛋白细胞的细胞培养物。注射后，PRTEE 评分中位数从术前的 78 分降至术后 6 周的 47 分、3 个月时的 35 分和 6 个月时的 12 分（p<0.05）。超声检查的愈合反应显示中位数降低：（1）撕裂数量，从 5 个减少至 2 个；（2）新血管数量，从 3 个减少至 1 个；和（3）肌腱厚度，从 4.35 减少至 4.2（p<0.05）。12 名患者中，11 名患者结果满意，仅 1 名患者在 3 个月治疗失败后进行手术。
可以在实验室中培养皮肤来源的肌腱细胞样细胞，产生丰富的胶原蛋白产生细胞。我们的初步研究表明，这些胶原蛋白产生细胞可以安全地注射到患者体内，并且在难治性外侧肱骨上髁炎患者中可能具有治疗价值。
