Department of Orthopaedic Surgery, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831 Japan.
Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, 162-8666 Japan.
J Orthop Sci. 2023 Mar;28(2):408-415. doi: 10.1016/j.jos.2021.12.020. Epub 2022 Jan 19.
Intra-articular administration of adipose tissue-derived stem cells (ADSC) is an alternative treatment option for knee osteoarthritis (OA) after conventional treatment fails; however, the clinical results related to the severity of OA grade and changes of cartilage volumes after the administration of ADSC is unknown. This study aimed to determine 1) clinical outcomes after the ADSC administration in knee OA with consideration of radiographic OA grades and 2) changes in cartilage volumes after ADSC administration.
This observational study included 86 knees from 51 patients who underwent intra-articular administration of cultured ADSC; 47 patients (80 knees) completed follow-up for 6 months (follow-up rate: 93%). The Knee injury and Osteoarthritis Outcome Scores (KOOS) were reported at baseline and 1, 3, and 6 months after the administration. The efficacy rate in the Outcome Measures in Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) was evaluated using the KOOS. Cartilage volume of the knee joint was measured using quantitative 3-dimensional magnetic resonance imaging (3D-MRI) software at baseline and 6 months in 52 knees in 31 patients (follow-up rate: 61%).
All items on the KOOS except "sports/recreation" improved significantly at 6 months with more significance in knees with a Kellgren-Lawrence (KL) grade 2 or 3 compared with KL grade 4 knees. The OMERACT-OARSI responder at 6 months was significantly greater in knees with KL grade 2 or 3 (64%) than in knees with KL grade 4 (42%, p = 0.045). Cartilage volume changes varied among patients and were not related to the changes in KOOS after ADSC administration.
Intra-articular administration of ADSC in knee OA improved KOOS at 6 months. The effects were more significant in knees with KL grade 2 or 3 than with KL grade 4. Changes in KOOS were not related to change in cartilage volumes after ADSC administration.
关节内注射脂肪组织源性干细胞(ADSC)是常规治疗失败后膝骨关节炎(OA)的另一种治疗选择;然而,ADSC 给药后与 OA 分级严重程度相关的临床结果以及软骨体积的变化尚不清楚。本研究旨在确定 1)ADSC 给药后膝 OA 的临床结果,同时考虑放射学 OA 分级,2)ADSC 给药后软骨体积的变化。
本观察性研究纳入了 51 例患者的 86 膝,这些患者接受了关节内注射培养的 ADSC;47 例患者(80 膝)完成了 6 个月的随访(随访率:93%)。在给药后 1、3 和 6 个月报告膝关节损伤和骨关节炎结果评分(KOOS)。使用 KOOS 评估关节炎临床试验结局测量指标-骨关节炎研究协会国际(OMERACT-OARSI)的有效率。在 31 例患者的 52 膝中(随访率:61%),使用定量 3 维磁共振成像(3D-MRI)软件在基线和 6 个月时测量膝关节软骨体积。
KOOS 的所有项目(“运动/娱乐”除外)在 6 个月时均有显著改善,KL 分级 2 或 3 的膝关节比 KL 分级 4 的膝关节改善更显著。KL 分级 2 或 3 的膝关节(64%)比 KL 分级 4 的膝关节(42%,p=0.045)在 6 个月时的 OMERACT-OARSI 应答者明显更多。患者之间的软骨体积变化不同,与 ADSC 给药后 KOOS 的变化无关。
关节内注射 ADSC 可改善膝骨关节炎患者的 KOOS,KL 分级 2 或 3 的膝关节效果更显著。ADSC 给药后 KOOS 的变化与软骨体积的变化无关。