Dilogo Ismail Hadisoebroto, Canintika Anissa Feby, Hartanto Bernadus Riyan, Pandelaki Jacub, Himantoko Irsa Gagah
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia.
Stem Cell Medical Technology Integrated Service Unit, Dr. Cipto Mangunkusumo Hospital, CMU 2 Building 5th Floor, Jl. Diponegoro 71, Jakarta 10430, Indonesia.
Biomedicines. 2024 Oct 14;12(10):2332. doi: 10.3390/biomedicines12102332.
Knee osteoarthritis (OA) significantly affects quality of life and imposes economic burdens due to its prevalence and the disability it causes. The efficacy of current treatments is limited to alleviating the symptoms, and they cannot be used for regenerative purposes. This study aims to evaluate the efficacy and safety of combining hyaluronic acid (HA), human umbilical cord-derived mesenchymal stem cells (hUC-MSCs), and synthetic human growth hormone (somatotropin) in the treatment of knee OA, assessing pain relief, functional improvement, and cartilage regeneration.
A four-arm, double-blind randomized trial was conducted with 51 knees from 28 subjects aged ≥50 with primary knee OA. The treatments involved were HA alone, HA with hUC-MSCs, HA with somatotropin, and a combination of all three. Efficacy was measured through the International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and visual analog score (VAS), and MRI T2 mapping of cartilage was conducted on pre-implantation at the 6th and 12th month.
All treatment arms showed improvements in the VAS and WOMAC scores over 12 months, suggesting some pain relief and functional improvement. However, MRI T2 mapping showed no significant cartilage regeneration across the groups.
While the combined use of HA, hUC-MSCs, and somatotropin improved symptoms of knee OA, it did not enhance cartilage regeneration significantly. This study highlights the potential of these combinations for symptom management but underscores the need for further research to optimize these therapies for regenerative outcomes.
膝关节骨关节炎（OA）因其高患病率及所致残疾显著影响生活质量并带来经济负担。当前治疗方法的疗效仅限于缓解症状，无法用于再生目的。本研究旨在评估透明质酸（HA）、人脐带间充质干细胞（hUC-MSCs）和合成人生长激素（生长激素）联合治疗膝关节OA的疗效和安全性，评估疼痛缓解、功能改善及软骨再生情况。
对28名年龄≥50岁的原发性膝关节OA患者的51个膝关节进行了一项四臂双盲随机试验。所涉及的治疗方法包括单独使用HA、HA联合hUC-MSCs、HA联合生长激素以及三者联合使用。通过国际膝关节文献委员会（IKDC）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及视觉模拟评分（VAS）来衡量疗效，并在植入前、第6个月和第12个月对软骨进行MRI T2成像。
所有治疗组在12个月内的VAS和WOMAC评分均有所改善，表明有一定的疼痛缓解和功能改善。然而，MRI T2成像显示各治疗组间软骨再生均无显著差异。
虽然HA、hUC-MSCs和生长激素联合使用改善了膝关节OA的症状，但并未显著促进软骨再生。本研究凸显了这些联合治疗方法在症状管理方面的潜力，但也强调了需要进一步研究以优化这些治疗方法，实现再生效果。
