Kim Jae-Do, Lee Gun Woo, Jung Gu Hee, Kim Cheung Kue, Kim Taehun, Park Jin Hyung, Cha Seong Sook, You Young-Bin
Department of Orthopaedic Surgery, Kosin University Gospel Hospital, 34 Am-nam Dong, Seo Gu, Pusan, 602-030, Republic of Korea,
Eur J Orthop Surg Traumatol. 2014 Dec;24(8):1505-11. doi: 10.1007/s00590-013-1393-9. Epub 2014 Jan 8.
As a treatment method of degenerative arthritis of knee, this study evaluated the clinical efficacy of the intra-articular injection of autologous bone marrow aspirates concentrate (BMAC) with adipose tissue.
Between April 2011 and May 2012, 41 patients (75 knees) who were diagnosed as a degenerative knee arthritis and underwent the BMAC injection with adipose tissue were included in this study. Mean age was 60.7 years old (ranged 53-80). Kellgren-Lawrence grade was used for assessing radiologic degree of osteoarthritis; there were each 12, 24, 33, and 6 cases of grade I, II, III, and IV. At preoperative and postoperative 3, 6, and 12 months, pain score using visual analogue scale (VAS) and functional scales were used for evaluation.
After the procedure, mean VAS score was decreased from 7.0 preoperatively to 4.1, 3.5, and 3.3 postoperatively 3, 6, and 12 months. And functional scores were also improved; International Knee Documentation Committee score (from 37.7 preoperatively to 59.3, 66.3, 69.3 postoperatively), SF-36 health score (from 31.5 to 43.5, 45.6, 47.7), knee and osteoarthritis outcome score (from 43.1 to 64.9, 68.5, 70.6), Lysholm Knee Questionnaire (from 37.3 to 65.4, 68.6, 71.0) were all increased after the procedure. When classified according to K-L grade, the improvement of VAS score in grade IV group was 8.2 preoperatively to 5.5, 5.3, and 5.7 postoperatively, which was significantly poorer than those of grade I-III groups. In the knee functional scales, similar pattern was checked.
BMAC injection significantly improved both knee pain and functions in the patients with degenerative arthritis of knee. Also, the injection would be more effective in early to moderate phases.
作为膝关节退行性关节炎的一种治疗方法，本研究评估了关节腔内注射自体骨髓抽吸浓缩物（BMAC）联合脂肪组织的临床疗效。
2011年4月至2012年5月间，本研究纳入了41例（75膝）被诊断为膝关节退行性关节炎并接受了BMAC联合脂肪组织注射的患者。平均年龄为60.7岁（范围53 - 80岁）。采用Kellgren-Lawrence分级评估骨关节炎的放射学程度；I级、II级、III级和IV级分别有12例、24例、33例和6例。在术前以及术后3个月、6个月和12个月，使用视觉模拟量表（VAS）疼痛评分和功能量表进行评估。
术后，平均VAS评分从术前的7.0分别降至术后3个月、6个月和12个月的4.1、3.5和3.3。功能评分也得到改善；国际膝关节文献委员会评分（从术前的37.7分别升至术后的59.3、66.3、69.3）、SF - 36健康评分（从31.5升至43.5、45.6、47.7）、膝关节和骨关节炎转归评分（从43.1升至64.9、68.5、70.6）、Lysholm膝关节问卷评分（从37.3升至65.4、68.6、71.0）在术后均有所提高。按K - L分级分类时，IV级组VAS评分的改善从术前的8.2降至术后的5.5、5.3和5.7，明显低于I - III级组。在膝关节功能量表方面，也呈现出类似模式。
BMAC注射显著改善了膝关节退行性关节炎患者的膝关节疼痛和功能。此外，该注射在早中期阶段会更有效。
