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冷冻保存的人脐带组织同种异体移植物补充髋关节骨关节炎相关软骨缺损的回顾性评估

Retrospective Evaluation of Cryopreserved Human Umbilical Cord Tissue Allografts in the Supplementation of Cartilage Defects Associated with Hip Osteoarthritis.

作者信息

Lai Albert, Tamea Conrad, Shou John, Okafor Anthony, Sparks Jay, Dodd Renee, Lambert Naomi, Woods Crislyn, Schulte Orion, Kovar Sarah, Barrett Tyler

机构信息

Desert Physical Medicine and Pain Management, Indio, CA 92201, USA.

Orthopedic Associates of Tampa Bay, Tampa, FL 33603, USA.

出版信息

J Clin Med. 2024 Jul 10;13(14):4040. doi: 10.3390/jcm13144040.

Abstract

: Osteoarthritis is a chronic disorder that affects the synovial joints by the progressive loss of articular cartilage. In the hip, the largest weight-bearing joint, the deterioration of articular cartilage and acetabular labrum can cause pain, diminishing the quality of life for patients. This study presents changes in reported pain scales from patients who received Wharton's jelly applications to cartilage deterioration in the hip from the observational retrospective repository at Regenative Labs. : Sixty-nine patients were selected based on inclusion criteria with patient-reported pain scales, including the Numeric Pain Rating Scale and the Western Ontario and McMaster University Osteoarthritis Index, collected at the initial application, 30, and 90-day follow-up visits. Thirteen patients received a second allograft application and had additional follow-up visits at 120 and 180 days. : Five of the six scales used showed a statistically significant improvement in average scores across the cohort. The greatest improvements were observed in the NPRS with a 31.36% improvement after 90 days and a 44.64% improvement for patients with two applications after 180 days. The minimal clinically important difference (MCID) was also calculated to determine the perceived value of care for each patient with 44.9% of patients exceeding the MCID and 78.3% reporting at least one level of improvement. : The positive outcomes for the patients in this cohort suggest WJ to be a promising alternative care option for patients with structural tissue degeneration in the hip refractory to the current standard of care.

摘要

骨关节炎是一种慢性疾病,通过关节软骨的逐渐丧失影响滑膜关节。在髋关节这个最大的承重关节中,关节软骨和髋臼唇的退化会导致疼痛,降低患者的生活质量。本研究展示了从再生实验室的观察性回顾性数据库中获取的,接受沃顿胶应用治疗的患者报告的疼痛量表变化情况,这些变化与髋关节软骨退化有关。

根据纳入标准选取了69名患者,收集了他们在初次应用、30天和90天随访时报告的疼痛量表,包括数字疼痛评分量表和西安大略和麦克马斯特大学骨关节炎指数。13名患者接受了第二次同种异体移植应用,并在120天和180天进行了额外的随访。

所使用的六个量表中有五个显示,整个队列的平均得分有统计学意义的改善。在数字疼痛评分量表中观察到最大的改善,90天后改善了31.36%,接受两次应用的患者在180天后改善了44.64%。还计算了最小临床重要差异(MCID),以确定每位患者护理的感知价值,44.9%的患者超过了MCID,78.3%的患者报告至少有一个改善水平。

该队列中患者的积极结果表明,对于目前护理标准难以治疗的髋关节结构组织退化患者,沃顿胶是一种有前景的替代护理选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e8c/11277460/6212468d1964/jcm-13-04040-g001.jpg

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