Khoury Miguel, Tabben Montassar, Rolón Alejandro U, Levi Lorena, Chamari Karim, D'Hooghe Pieter
Cleveland Orthopedics, Buenos Aires, Argentina.
Aspetar Qatar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar.
J Exp Orthop. 2021 Jan 26;8(1):6. doi: 10.1186/s40634-020-00320-z.
Study the effect of Adipose derived stromal cells (ASCs) injection as therapeutic procedure on the common extensor tendinopathy.
Eighteen Tennis players with chronic, recalcitrant LET (who have previously been unsuccessfully treated with nonoperative treatments) underwent clinical evaluation and magnetic resonance imaging (MRI) before intervention. Stromal vascular fraction cells (SVF) were expanded by in vitro culture and ASCs were obtained and characterized by flow cytometry. ASCs were injected into the site of tendinopathy (identified by ultrasound imaging at the origin of the common extensor tendon) on a single occasion followed by physiotherapy. Players underwent serial clinical evaluations during a 12-month period and repeated MRI at 6-month post-injection.
At 6-month clinical evaluation revealed significant improvements compared to baseline in mean Visual Analog Scale (VAS) scores for: (1) maximum pain score (from 6.28 ± 1.65, to 1.0 ± 0.43; p < .001); (2) Mean quick Disabilities of the Arm, Shoulder and Hand (QuickDASH-Compulsory score: 51.38 ± 12.02 to 12.33 ± 4.66; p < .001); (3) QuickDASH-Sport score: 56.94 ± 15.44 to 8.68 ± 8.86; p < .001). Validated MRI scoring system grade of tendinopathy also improved significantly: 4.22 ± 0.26 to 2.22 ± 0.10 (p < .001). At 12-month from injection, VAS maximun pain score further decreased to 0.74 ± 0.44 (p < .001) and QuickDASH-Compulsory score to 5.56 ± 3.58 (p < .001). Average time to return to play tennis was 3,31 ± 0,61 month post-intervention.
Tennis players with recalcitrant LET showed significant clinical improvement and structural repair at the origin of the common tendon origin after injection of autologous ASCs. Results of this study are promising and open a new biological therapeutic modality to treat LET. Even if the results of this pilot study are positive, future well-designed studies, i.e. prospective randomized trials are needed to define the role of cell therapy in treating LET.
研究脂肪来源的间充质干细胞（ASCs）注射作为一种治疗方法对常见伸肌肌腱病的影响。
18名患有慢性、顽固性外侧伸肌肌腱炎（LET）的网球运动员（此前非手术治疗均未成功）在干预前接受了临床评估和磁共振成像（MRI）检查。通过体外培养扩增基质血管成分细胞（SVF），获得ASCs并通过流式细胞术进行表征。将ASCs一次性注射到肌腱病部位（通过超声成像确定为常见伸肌肌腱起点处），随后进行物理治疗。运动员在12个月内接受了系列临床评估，并在注射后6个月重复进行MRI检查。
在6个月的临床评估中，与基线相比，平均视觉模拟评分（VAS）在以下方面有显著改善：（1）最大疼痛评分（从6.28±1.65降至1.0±0.43；p<0.001）；（2）手臂、肩部和手部快速残疾评定量表（QuickDASH-必填项评分：从51.38±12.02降至12.33±4.66；p<0.001）；（3）QuickDASH-运动评分：从56.94±15.44降至8.68±8.86；p<0.001）。经过验证的MRI肌腱病评分系统等级也有显著改善：从4.22±0.26降至2.22±0.10（p<0.001）。在注射后12个月，VAS最大疼痛评分进一步降至0.74±0.44（p<0.001），QuickDASH-必填项评分降至5.56±3.58（p<0.001）。干预后平均恢复打网球的时间为3.31±0.61个月。
患有顽固性LET的网球运动员在注射自体ASCs后，在常见肌腱起点处显示出显著的临床改善和结构修复。本研究结果很有前景，为治疗LET开辟了一种新的生物治疗方式。即使这项初步研究结果是阳性的，仍需要未来设计良好的研究，即前瞻性随机试验来确定细胞疗法在治疗LET中的作用。
