Department of Orthopedic Surgery, College of Medicine, Inha University, Incheon, Korea.
Cell Transplant. 2020 Jan-Dec;29:963689720943581. doi: 10.1177/0963689720943581.
Biological repair of cartilage lesions remains a significant clinical challenge. A wide variety of methods involving mesenchymal stem cells (MSCs) have been introduced. Because of the limitation of the results, most of the treatment methods have not yet been approved by the Food and Drug Administration (FDA). However, bone marrow aspirate concentrate (BMAC) and human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) implantation were approved by Korea FDA. The aim of this study was to evaluate clinical and magnetic resonance imaging (MRI) outcomes after two different types of MSCs implantation in knee osteoarthritis. Fifty-two patients (52 knees) who underwent cartilage repair surgery using the BMAC (25 knees) and hUCB-MSCs (27 knees) were retrospectively evaluated for 2 years after surgery. Clinical outcomes were evaluated according to the score of visual analogue scale (VAS), the International Knee Documentation Committee (IKDC) subjective, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Cartilage repair was assessed according to the modified Magnetic Resonance Observation of Cartilage Repair Tissue (M-MOCART) score and the International Cartilage Repair Society (ICRS) cartilage repair scoring system. At 2-year follow-up, clinical outcomes including VAS, IKDC, and KOOS significantly improved ( < 0.05) in both groups; however, there were no differences between two groups. There was no significant difference in M-MOCART [1-year ( = 0.261), 2-year ( = 0.351)] and ICRS repair score ( = 0.655) between two groups. Both groups showed satisfactory clinical and MRI outcomes. Implantation of MSCs from BMAC or hUCB-MSCs is safe and effective for repairing cartilage lesion. However, large cases and a well-controlled prospective design with long-term follow-up studies are needed.
软骨损伤的生物修复仍然是一个重大的临床挑战。已经引入了涉及间充质干细胞 (MSCs) 的各种方法。由于结果的限制，大多数治疗方法尚未获得食品和药物管理局 (FDA) 的批准。然而，骨髓抽吸浓缩物 (BMAC) 和人脐带血衍生的间充质干细胞 (hUCB-MSCs) 植入已获得韩国 FDA 的批准。本研究旨在评估两种不同类型的 MSC 植入膝关节骨关节炎后的临床和磁共振成像 (MRI) 结果。对接受 BMAC（25 膝）和 hUCB-MSCs（27 膝）软骨修复手术的 52 例患者（52 膝）进行了回顾性评估，术后 2 年。临床结果根据视觉模拟量表 (VAS) 评分、国际膝关节文献委员会 (IKDC) 主观评分和膝关节损伤和骨关节炎结果评分 (KOOS) 进行评估。根据改良磁共振观察软骨修复组织 (M-MOCART) 评分和国际软骨修复协会 (ICRS) 软骨修复评分系统评估软骨修复情况。在 2 年随访时，两组的临床结果（VAS、IKDC 和 KOOS）均显著改善（<0.05）；然而，两组之间没有差异。两组之间的 M-MOCART [1 年（=0.261），2 年（=0.351）] 和 ICRS 修复评分（=0.655）没有显著差异。两组均表现出满意的临床和 MRI 结果。植入 BMAC 或 hUCB-MSCs 的 MSC 安全且有效，可修复软骨损伤。然而，需要进行大病例、良好对照的前瞻性设计和长期随访研究。
