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自体脂肪间充质干细胞治疗在剥脱性骨软骨炎手术干预失败后膝关节大面积骨软骨缺损治疗中的效果——一项病例研究

The effect of autologous adipose derived mesenchymal stem cell therapy in the treatment of a large osteochondral defect of the knee following unsuccessful surgical intervention of osteochondritis dissecans - a case study.

作者信息

Freitag Julien, Shah Kiran, Wickham James, Boyd Richard, Tenen Abi

机构信息

Charles Sturt University, NSW, Australia.

Magellan Stem Cells, VIC, Australia.

出版信息

BMC Musculoskelet Disord. 2017 Jul 14;18(1):298. doi: 10.1186/s12891-017-1658-2.

DOI:10.1186/s12891-017-1658-2
PMID:28705162
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5513163/
Abstract

BACKGROUND

A prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD).

CASE PRESENTATION

After failed conventional management of OCD a patient undergoes intra-articular MSC therapy. Patient outcome measures included the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Structural outcome was assessed using MRI with the novel technique of T2 mapping used to indicate cartilage quality. Following MSC therapy the patient reported improvement in pain and function as measured by NPRS, WOMAC and KOOS. Repeat MRI analysis showed regeneration of cartilage. MRI T2 mapping indicated hyaline like cartilage regrowth.

CONCLUSION

In this report, the use of MSCs, after unsuccessful conventional OCD management, resulted in structural, functional and pain improvement. These results highlight the need to further study the regenerative potential of MSC therapy.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trial Registry Number - ACTRN12615000258550 (Date registered 19/03/2015 - retrospectively registered).

摘要

背景

对自体脂肪间充质干细胞（MSC）疗法在治疗膝关节骨软骨缺损合并剥脱性骨软骨炎（OCD）手术干预失败后早期进展性骨关节炎中的作用进行前瞻性分析。

病例报告

在OCD传统治疗失败后，一名患者接受了关节内MSC治疗。患者的预后指标包括数字疼痛评分量表（NPRS）、西安大略和麦克马斯特大学关节炎指数（WOMAC）以及膝关节损伤和骨关节炎预后评分（KOOS）。使用MRI结合T2映射新技术评估结构预后，以指示软骨质量。MSC治疗后，患者报告NPRS、WOMAC和KOOS测量的疼痛和功能有所改善。重复MRI分析显示软骨再生。MRI T2映射表明有透明样软骨再生。

结论

在本报告中，在传统OCD治疗失败后使用MSC导致结构、功能和疼痛改善。这些结果凸显了进一步研究MSC疗法再生潜力的必要性。

试验注册

澳大利亚和新西兰临床试验注册号 - ACTRN12615000258550（注册日期2015年3月19日 - 追溯注册）。

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