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一项回顾性研究:通过关节镜在支架上实施,比较人脐带源间充质干细胞和骨髓抽吸浓缩物间充质干细胞对膝关节软骨修复缺损的疗效

Comparison of the Efficacy of Human Umbilical Cord-Derived and Bone Marrow Aspirate Concentrate Mesenchymal Stem Cells for Cartilage Repair Defects of the Knee via Arthroscopic Implementation on Scaffolds in a Retrospective Study.

作者信息

Pałka Karol, Sadlik Bogusław, Kamiński Paweł, Bułdak Rafał J, Dobrakowski Michał

机构信息

Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland.

College of Physiotherapy in Wrocław, ul. Kościuszki 4, 50-038 Wrocław, Poland.

出版信息

J Pers Med. 2024 Feb 20;14(3):220. doi: 10.3390/jpm14030220.

Abstract

Injuries to the articular cartilage of the human knee joint, commonly resulting from trauma, inflammation, or age- and activity-related wear and tear, have significant implications, primarily leading to osteoarthritis (OA). Conservative treatments for such injuries often yield suboptimal clinical outcomes. Surgical interventions using current methods may not consistently provide satisfactory results, largely due to the formation of low-quality scar tissue lacking the biomechanical properties of hyaline cartilage. In this retrospective study, we compared the results of two promising methods for regenerating cartilage defects in the knee joints using scaffolds soaked with stem cells of different origins: bone marrow aspirate concentrate mesenchymal stem cells (BMAC-MSCs) and human umbilical cord-derived mesenchymal stem cells (hUCB-MSCs). We evaluated 39 patients (39 knees, hUCB-MSCs: 20 knees, BMAC: 19 knees) at the 12-month follow-up using VAS, KOOS, Lysholm scales and radiologically with M-MOCART 2.0 score. The analysis demonstrated substantial overall improvement in both groups, notably reflected in enhanced quality of life for the patients. Interestingly, the final scores in the hUCB-MSCs group were comparable to those in the BMAC-MSCs group, with no statistically significant differences observed, despite variations in preoperative age and lesion size. Notably, the hUCB-MSCs group consisted of significantly older individuals with larger lesion sizes. Both procedures were found to be safe, and improvement was observed in both groups, which holds promise for future clinical investigations.

摘要

人类膝关节的关节软骨损伤通常由创伤、炎症或与年龄和活动相关的磨损引起,具有重大影响,主要会导致骨关节炎(OA)。此类损伤的保守治疗往往产生不理想的临床结果。使用当前方法的手术干预可能无法始终提供令人满意的结果,这主要是由于形成了缺乏透明软骨生物力学特性的低质量瘢痕组织。在这项回顾性研究中,我们比较了两种有前景的方法的结果,这两种方法是使用浸泡有不同来源干细胞的支架来修复膝关节软骨缺损:骨髓抽吸浓缩物间充质干细胞(BMAC-MSCs)和人脐带间充质干细胞(hUCB-MSCs)。我们在12个月的随访中使用视觉模拟评分法(VAS)、膝关节损伤和骨关节炎疗效评分(KOOS)、Lysholm量表对39例患者(39个膝关节,hUCB-MSCs组:20个膝关节,BMAC组:19个膝关节)进行评估,并通过M-MOCART 2.0评分进行影像学评估。分析表明两组总体均有显著改善,尤其体现在患者生活质量的提高上。有趣的是,hUCB-MSCs组的最终评分与BMAC-MSCs组相当,尽管术前年龄和损伤大小存在差异,但未观察到统计学上的显著差异。值得注意的是,hUCB-MSCs组患者年龄明显更大,损伤尺寸也更大。两种手术方法均被证明是安全的,两组均有改善,这为未来的临床研究带来了希望。

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