Mardones Rodrigo, Via Alessio Giai, Jofré Claudio, Minguell José, Rodriguez Claudio, Tomic Alexander, Salineros Matias
Department of Orthopaedic Surgery, Adult Reconstruction Surgery Hip/Knee and Hip Arthroscopy, Santiago de Chile, Chile; Regenerative Cell Therapy Center, Clínica Las Condes, Santiago de Chile, Chile.
Department of Orthopaedic Surgery, Adult Reconstruction Surgery Hip/Knee and Hip Arthroscopy, Santiago de Chile, Chile.
Muscles Ligaments Tendons J. 2016 Dec 21;6(3):361-366. doi: 10.11138/mltj/2016.6.3.361. eCollection 2016 Jul-Sep.
Chondral injuries are commonly related to poor clinical outcome, but recent data showed some improvements in function and pain after hip arthroscopy. Cell-based therapies represent an appealing alternative strategy for cartilage regeneration, and interesting results have been recently reported after intra-articular injections of mesenchymal stem cells (MSCs). The results of hip arthroscopy for femoroacetabular impingement (FAI) and intra-articular injections of autologous expanded bone marrow - MSCs (BM-MSCs) are reported in this retrospective study.
Twenty patients (29 hips) received hip arthroscopy for FAI and focal cartilage injuries or mild to moderate osteoarthrosis (OA). Three intra-articular injections of 20×10 BM-MSCs were injected from 4 to 6 weeks postoperative. The modified Harris Hip score (mHHS), the WOMAC score, the VAIL score and VAS score were administered to all patients.
The mean age of the patients was 51.8 years, and the mean follow-up was 24 months. The median preoperative mHHS, WOMAC and VAIL scores were 64.3, 73 and 56.5 respectively, and they increased to 91, 97 and 83 at final follow up (p<0.05). The VAS score also improved from a median of 6 to 2. Four patients received a THA (13% of the hips) at the median of 9 months post intervention (range 6-36 months). Six patients referred pain after the injection of MSCs, which improved with oral pain killers. No major complications were reported.
BM-MSCc injections in combination with hip arthroscopy may improve the quality of life and functional score in patient with FAI and cartilage injuries which are still not candidate to a THA.
IV case series.
软骨损伤通常与临床预后不佳相关，但近期数据显示髋关节镜检查后功能和疼痛有一定改善。基于细胞的疗法是软骨再生的一种有吸引力的替代策略，最近关节内注射间充质干细胞（MSC）后已有一些有趣的结果报道。本回顾性研究报告了髋关节镜治疗股骨髋臼撞击症（FAI）以及关节内注射自体扩增骨髓间充质干细胞（BM-MSC）的结果。
20例患者（29髋）因FAI及局灶性软骨损伤或轻至中度骨关节炎（OA）接受髋关节镜检查。术后4至6周进行3次关节内注射，每次注射20×10的BM-MSC。对所有患者进行改良Harris髋关节评分（mHHS）、WOMAC评分、VAIL评分和视觉模拟评分（VAS）。
患者平均年龄51.8岁，平均随访24个月。术前mHHS、WOMAC和VAIL评分中位数分别为64.3、73和56.5，末次随访时分别增至91、97和83（p<0.05）。VAS评分中位数也从6改善至2。4例患者在干预后中位数9个月（范围6 - 36个月）接受了全髋关节置换术（THA，占髋部的13%）。6例患者在注射MSC后出现疼痛，口服止痛药物后改善。未报告重大并发症。
BM-MSC注射联合髋关节镜检查可改善仍不适合进行THA的FAI和软骨损伤患者的生活质量和功能评分。
IV级病例系列。
