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髌下脂肪垫来源的间充质干细胞治疗膝关节骨关节炎

Infrapatellar fat pad-derived mesenchymal stem cell therapy for knee osteoarthritis.

作者信息

Koh Yong-Gon, Choi Yun-Jin

机构信息

Department of Orthopedic Surgery, Yonsei Sarang Hospital, Seoul, South Korea.

出版信息

Knee. 2012 Dec;19(6):902-7. doi: 10.1016/j.knee.2012.04.001. Epub 2012 May 14.

Abstract

PURPOSE

The aim of the study was to determine if isolated mesenchymal stem cells (MSCs) derived from the infrapatellar fat pad could effectively improve clinical results when percutaneously injected into arthritic knees.

LEVEL OF EVIDENCE

Therapeutic case-control study; Level III.

METHODS

Twenty five stem cell injections combined with arthroscopic debridement were administered to patients with knee OA. A mean of 1.89 × 10(6) stem cells were prepared with approximately 3.0 mL of platelet-rich plasma (PRP) and injected in the selected knees of patients in the study group.

RESULTS

The mean Lysholm, Tegner activity scale, and VAS scores of patients in the study group improved significantly by the last follow-up visit. No major adverse events related to the injections were observed during the treatment and follow-up periods. The results were compared between the study and control groups, in which the patients had undergone arthroscopic debridement and PRP injection without stem cells. Although the preoperative mean Lysholm, Tegner activity scale, and VAS scores of the study group were significantly poorer than those of the control group, the clinical results at the last follow-up visit were similar and not significantly different between the two groups.

CONCLUSIONS

The short-term results of our study are encouraging and demonstrate that infrapatellar fat pad-derived MSC therapy with intraarticular injections is safe, and provides assistance in reducing pain and improving function in patients with knee OA.

摘要

目的

本研究旨在确定经皮注射入患有关节炎的膝关节时,从髌下脂肪垫分离出的间充质干细胞(MSCs)是否能有效改善临床效果。

证据水平

治疗性病例对照研究;三级。

方法

对25例膝骨关节炎患者进行干细胞注射联合关节镜清理术。研究组患者平均制备1.89×10⁶个干细胞,并与约3.0 mL富血小板血浆(PRP)混合,注射入选定的膝关节。

结果

到最后一次随访时,研究组患者的Lysholm评分、Tegner活动量表评分和视觉模拟评分(VAS)均显著改善。在治疗和随访期间未观察到与注射相关的重大不良事件。将研究组结果与对照组进行比较,对照组患者接受了关节镜清理术和PRP注射但未注射干细胞。虽然研究组术前的平均Lysholm评分、Tegner活动量表评分和VAS评分明显低于对照组,但最后一次随访时两组的临床结果相似,无显著差异。

结论

本研究的短期结果令人鼓舞,表明髌下脂肪垫来源的间充质干细胞关节内注射治疗是安全的,有助于减轻膝骨关节炎患者的疼痛并改善其功能。

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