Dall'Oca Carlo, Breda Stefano, Elena Nicholas, Valentini Roberto, Samaila Elena Manuela, Magnan Bruno
Azienda Ospedaliera Universitaria Integrata Verona, Ortopedia e Traumatologia B, Verona, Italy.
Acta Biomed. 2019 Jan 10;90(1-S):75-80. doi: 10.23750/abm.v90i1-S.8084.
Osteoarthritis will become even more common in the near future since the average life span is steadily growing. Pain and loss of function are the main complaints reported by patients, inevitably leading towards a worsened daily life performance. New modern techniques have been developed with advanced cell based therapies. Mesenchymal stem cells (MSC) have the inner ability to mature into different types of cells depending on the stimuli they undergo. This technique has already been proven successful in the knee and, with this retrospective study, we would like to assess its feasibility in the hip joint.
6 consecutive patients affected by hip osteoarthritis were treated by intra-articular injection of autologous adipose-derived MSC between June 2017 and June 2018. Our study included only patients with constant hip pain resistant conservative treatment and OA graded 0-2 on the Tonnis grading scale. All 6 patients were evaluated in the preoperative setting and at the 6 months post-operative mark.
The HHS showed an improvement from the pre-operative baseline mean value of 67.2±3.4 to the 84.6±6.3 post-operative value. Moreover, the WOMAC score dropped from a baseline score of 36.3±4.7 to 19.8±3.4 at 6 months' post-op follow up visit.
MSC Lipogems is a fairly easy technique. No adverse effects were recorded in our experience. Preliminary results showed a positive outcome according to all the grading systems used in this study even though a longer follow up is needed to validate this technique.
由于平均寿命稳步增长,骨关节炎在不久的将来会变得更加常见。疼痛和功能丧失是患者报告的主要症状,不可避免地导致日常生活表现恶化。基于先进细胞疗法的新现代技术已经得到发展。间充质干细胞(MSC)具有根据所经历的刺激成熟为不同类型细胞的内在能力。这项技术已在膝关节中被证明是成功的,通过这项回顾性研究,我们想评估其在髋关节中的可行性。
2017年6月至2018年6月期间,对6例连续的髋关节骨关节炎患者进行关节内注射自体脂肪来源的MSC治疗。我们的研究仅纳入那些持续存在髋关节疼痛且保守治疗无效、Tonnis分级为0 - 2级的患者。所有6例患者在术前和术后6个月进行评估。
髋关节Harris评分(HHS)从术前基线平均值67.2±3.4提高到术后值84.6±6.3。此外,Western Ontario和McMaster大学骨关节炎指数(WOMAC)评分从基线评分36.3±4.7下降到术后6个月随访时的19.8±3.4。
Lipogems间充质干细胞技术是一种相当简便的技术。根据我们的经验,未记录到不良反应。初步结果显示,根据本研究中使用的所有分级系统,结果均为阳性,尽管需要更长时间的随访来验证这项技术。