Department of Orthopedics and Traumatology, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Shaoxing 312000, Zhejiang, China.
Department of Orthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang, China.
Postgrad Med J. 2024 May 18;100(1184):399-406. doi: 10.1093/postmj/qgae009.
Multicompartmental osteoarthritis (MOA) in both tibiofemoral and patellofemoral joints is a more commonly occurring, but neglected, clinical condition, and we examined the short-term safety and efficacy of autologous stromal vascular fractions (SVFs) for MOA using a single-blind, prospective, randomized, placebo-controlled trial.
Seventy MOA patients were recruited and randomly assigned to the SVF group and hyaluronic acid (HA) group (control group). The scores of visual analog scale, the Western Ontario and McMaster University Osteoarthritis Index, and the Samsung Medical Center patellofemoral scoring system were assessed and compared between the two groups 3, 6 and 12 months after treatment.
The SVF group had significantly better visual analog scale scores than the HA group at 6 and 12 months after treatment and had better Western Ontario and McMaster University Osteoarthritis Index scores than the HA group only at 6 months after treatment. For Samsung Medical Center patellofemoral scoring system of the patellofemoral joint, the SVF group had significantly better scores than the control group at all postoperative time points. The proportion of patients whose visual analog scale and Western Ontario and McMaster University Osteoarthritis Index scores were above the minimal clinically important improvement was higher in the SVF group than in the HA group in the majority of assessments. The improvement of bone marrow by SVF treatment was significantly better than that of the HA group as observed by pre- and postoperative Magnetic resonance imaging (MRI).
Multiple intra-articular injection of autologous SVF reduces pain and improves function in the short term in patients with early or midstage MOA. However, there was heterogeneity in the improvement of overall knee and isolated patellofemoral joint after treatment.
在髌股关节和胫股关节中出现多间室性骨关节炎（MOA）是一种更常见但被忽视的临床情况，我们使用单盲、前瞻性、随机、安慰剂对照试验来检查自体基质血管成分（SVF）治疗 MOA 的短期安全性和疗效。
招募了 70 名 MOA 患者，并将其随机分配到 SVF 组和透明质酸（HA）组（对照组）。在治疗后 3、6 和 12 个月，评估并比较两组的视觉模拟量表评分、西安大略和麦克马斯特大学骨关节炎指数评分以及三星医疗中心髌股关节评分系统评分。
治疗后 6 和 12 个月，SVF 组的视觉模拟量表评分明显优于 HA 组，而仅在治疗后 6 个月，SVF 组的西安大略和麦克马斯特大学骨关节炎指数评分优于 HA 组。对于髌股关节的三星医疗中心髌股关节评分系统，SVF 组在所有术后时间点的评分均明显优于对照组。在大多数评估中，SVF 组视觉模拟量表和西安大略和麦克马斯特大学骨关节炎指数评分高于最小临床重要改善的患者比例均高于 HA 组。SVF 治疗后骨髓改善明显优于 HA 组，这可通过术前和术后磁共振成像（MRI）观察到。
在早期或中期 MOA 患者中，多次关节内注射自体 SVF 可在短期内减轻疼痛并改善功能。然而，在治疗后整体膝关节和孤立髌股关节的改善方面存在异质性。
