Kim Y S, Choi Y J, Lee S W, Kwon O R, Suh D S, Heo D B, Koh Y G
Center for Stem Cell & Arthritis Research, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea.
Department of Radiology, Yonsei Sarang Hospital, Seoul, Republic of Korea.
Osteoarthritis Cartilage. 2016 Feb;24(2):237-45. doi: 10.1016/j.joca.2015.08.009. Epub 2015 Aug 28.
Cartilage regenerative procedures using the cell-based tissue engineering approach involving mesenchymal stem cells (MSCs) have been receiving increased interest because of their potential for altering the progression of osteoarthritis (OA) by repairing cartilage lesions. The aim of this study was to investigate the clinical and magnetic resonance imaging (MRI) outcomes of MSC implantation in OA knees and to determine the association between clinical and MRI outcomes.
Twenty patients (24 knees) who underwent arthroscopic MSC implantation for cartilage lesions in their OA knees were evaluated at 2 years after surgery. Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed according to the MRI Osteoarthritis Knee Score (MOAKS) and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.
The clinical outcomes significantly improved (P < 0.001 for both). The cartilage lesion grades (as described in MOAKS [grades for size of cartilage-loss area and percentage of full-thickness cartilage loss]) at follow-up MRI were significantly better than the preoperative values (P < 0.001 for both). The clinical outcomes at final follow-up were significantly correlated with the MOAKS and MOCART score at follow-up MRI (P < 0.05 for all).
Considering the encouraging clinical and MRI outcomes obtained and the significant correlations noted between the clinical and MRI outcomes, MSC implantation seems to be useful for repairing cartilage lesions in OA knees. However, a larger sample size and long-term studies are needed to confirm our findings.
基于间充质干细胞（MSCs）的细胞组织工程方法用于软骨再生手术，因其具有通过修复软骨损伤改变骨关节炎（OA）病程的潜力而受到越来越多的关注。本研究的目的是调查OA膝关节中MSCs植入的临床和磁共振成像（MRI）结果，并确定临床和MRI结果之间的关联。
对20例（24个膝关节）因OA膝关节软骨损伤接受关节镜下MSCs植入的患者在术后2年进行评估。根据国际膝关节文献委员会（IKDC）评分和Tegner活动量表评估临床结果，并根据MRI骨关节炎膝关节评分（MOAKS）和软骨修复组织磁共振观察（MOCART）评分评估软骨修复情况。
临床结果显著改善（两者P均<0.001）。随访MRI时的软骨损伤分级（如MOAKS中所述[软骨缺损面积大小和全层软骨损失百分比的分级]）明显优于术前值（两者P均<0.001）。最终随访时的临床结果与随访MRI时的MOAKS和MOCART评分显著相关（所有P均<0.05）。
考虑到所获得的令人鼓舞的临床和MRI结果以及临床和MRI结果之间的显著相关性，MSCs植入似乎对修复OA膝关节软骨损伤有用。然而，需要更大的样本量和长期研究来证实我们的发现。
