Stems Medical Clinic, Seoul, Republic of Korea.
PLoS One. 2013 May 20;8(5):e64569. doi: 10.1371/journal.pone.0064569. Print 2013.
Mesenchymal stem cells from several sources (bone marrow, synovial tissue, cord blood, and adipose tissue) can differentiate into variable parts (bones, cartilage, muscle, and adipose tissue), representing a promising new therapy in regenerative medicine. In animal models, mesenchymal stem cells have been used successfully to regenerate cartilage and bones. However, there have been no follow-up studies on humans treated with adipose-tissue-derived stem cells (ADSCs) for the chondromalacia patellae. To obtain ADSCs, lipoaspirates were obtained from lower abdominal subcutaneous adipose tissue. The stromal vascular fraction was separated from the lipoaspirates by centrifugation after treatment with collagenase. The stem-cell-containing stromal vascular fraction was mixed with calcium chloride-activated platelet rich plasma and hyaluronic acid, and this ADSCs mixture was then injected under ultrasonic guidance into the retro-patellar joints of all three patients. Patients were subjected to pre- and post-treatment magnetic resonance imaging (MRI) scans. Pre- and post-treatment subjective pain scores and physical therapy assessments measured clinical changes. One month after the injection of autologous ADSCs, each patient's pain improved 50-70%. Three months after the treatment, the patients' pain improved 80-90%. The pain improvement persisted over 1 year, confirmed by telephone follow ups. Also, all three patients did not report any serious side effects. The repeated magnetic resonance imaging scans at three months showed improvement of the damaged tissues (softened cartilages) on the patellae-femoral joints. In patients with chondromalacia patellae who have continuous anterior knee pain, percutaneous injection of autologous ADSCs may play an important role in the restoration of the damaged tissues (softened cartilages). Thus, ADSCs treatment presents a glimpse of a new promising, effective, safe, and non-surgical method of treatment for chondromalacia patellae.
来自多个来源（骨髓、滑膜组织、脐血和脂肪组织）的间充质干细胞可以分化为不同的组织（骨骼、软骨、肌肉和脂肪组织），这代表了再生医学中一种有前途的新疗法。在动物模型中，间充质干细胞已成功用于软骨和骨骼的再生。然而，对于接受脂肪组织来源的干细胞（ADSCs）治疗髌股软骨软化症的患者，尚无后续研究。为了获得 ADSCs，从下腹部皮下脂肪组织中获取脂肪抽吸物。用胶原酶处理后，通过离心将间质血管部分从脂肪抽吸物中分离出来。将含有干细胞的间质血管部分与氯化钙激活的富含血小板的血浆和透明质酸混合，然后在超声引导下将 ADSCs 混合物注入所有三名患者的髌后关节。对患者进行治疗前后的磁共振成像（MRI）扫描。治疗前后的主观疼痛评分和物理治疗评估测量了临床变化。在注射自体 ADSCs 一个月后，每位患者的疼痛减轻了 50-70%。治疗三个月后，患者的疼痛减轻了 80-90%。通过电话随访证实，疼痛改善持续了 1 年以上。此外，所有三名患者均未报告任何严重的副作用。治疗三个月时的重复磁共振成像扫描显示髌股关节上受损组织（软化软骨）有所改善。对于髌股软骨软化症患者，持续出现前膝疼痛，经皮注射自体 ADSCs 可能在恢复受损组织（软化软骨）方面发挥重要作用。因此，ADSCs 治疗为髌股软骨软化症提供了一种有前途的、有效、安全和非手术治疗方法。
