Yamagami Ryota, Terao Tomohiro, Kasai Taro, Ishikura Hisatoshi, Hatano Masaki, Higuchi Junya, Yoshida Shuichi, Arino Yusuke, Murakami Ryo, Sato Masashi, Maenohara Yuji, Makii Yuma, Matsuzaki Tokio, Inoue Keita, Tsuji Shinsaku, Tanaka Sakae, Saito Taku
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Ochanomizu Cell Clinic, Tokyo, Japan.
Regen Ther. 2024 Dec 26;28:227-234. doi: 10.1016/j.reth.2024.12.012. eCollection 2025 Mar.
This study aimed to determine the association between the baseline magnetic resonance imaging (MRI) findings and clinical outcomes after articular injection of adipose-derived mesenchymal stem cells (ASCs) for knee osteoarthritis (KOA).
This retrospective study included 149 patients with varus-type KOA treated with a single intraarticular ASC injection. All patients underwent a MRI evaluation before treatment. Patients were categorized following the MRI Osteoarthritis Knee Score (MOAKS) system cartilage score into the mild, moderate, or severe KOA groups. Additionally, joint effusion and synovitis, bone marrow lesions (BMLs), and meniscal extrusions were graded with the MOAKS. Knee Osteoarthritis Outcome Score (KOOS) was obtained at baseline, 1-, 3-, 6-, and 12-month posttreatment. The responder rate in the Outcome Measures in Arthritis Clinical Trials-Osteoarthritis Research Society International was assessed with the KOOS. Multivariate logistic regression analyses were conducted to determine factors associated with the responder rate.
All KOOS subscales significantly enhanced with the greatest improvement from baseline to 6 months which plateaued between 6 and 12 months. The responder rate was 65.4 % in the mild/moderate KOA compared to 35.2 % in the severe KOA at 12 months. Lower OA grade (odds ratio [OR]: 0.52; 95 % confidence interval (CI): 0.31-0.88; = 0.015), smaller BMLs in medial femoral condyle (OR: 0.36; 95 % CI: 0.14-0.94; = 0.037), and less meniscal extrusion (OR: 0.31; 95 % CI: 0.11-0.89; = 0.029) were associated with higher responder rate at 6 months in multivariable logistic regression analysis. The factors associated with higher responder rate at 12 months included lower OA grade (OR: 0.42; 95 % CI: 0.25-0.73; = 0.002) and younger age (OR: 1.04; 95 % CI: 1.00-1.08; = 0.042).
ASC treatment for KOA enhanced short-term clinical outcomes. MRI findings, including cartilage lesions, BMLs, and meniscal extrusion, were associated with responder rate, helping physicians identify which patients may benefit from this therapy.
本研究旨在确定膝关节骨关节炎（KOA）关节注射脂肪间充质干细胞（ASC）后，基线磁共振成像（MRI）结果与临床结局之间的关联。
本回顾性研究纳入了149例接受单次关节内ASC注射治疗的内翻型KOA患者。所有患者在治疗前均接受了MRI评估。根据MRI骨关节炎膝关节评分（MOAKS）系统软骨评分，将患者分为轻度、中度或重度KOA组。此外，根据MOAKS对关节积液和滑膜炎、骨髓病变（BML）以及半月板挤出情况进行分级。在基线、治疗后1、3、6和12个月时获取膝关节骨关节炎结局评分（KOOS）。采用KOOS评估骨关节炎临床试验-国际骨关节炎研究学会结局测量中的缓解率。进行多因素逻辑回归分析以确定与缓解率相关的因素。
所有KOOS子量表均显著提高，从基线到6个月改善最大，在6至12个月之间趋于平稳。12个月时，轻度/中度KOA的缓解率为65.4%，而重度KOA为35.2%。在多因素逻辑回归分析中，较低的骨关节炎等级（比值比[OR]：0.52；95%置信区间[CI]：0.31 - 0.88；P = 0.015）、股骨内侧髁较小的BML（OR：0.36；95% CI：0.14 - 0.94；P = 0.037）以及较少的半月板挤出（OR：0.31；95% CI：0.11 - 0.89；P = 0.029）与6个月时较高的缓解率相关。与12个月时较高缓解率相关的因素包括较低的骨关节炎等级（OR：0.42；95% CI：0.25 - 0.73；P = 0.002）和较年轻的年龄（OR：1.04；95% CI：1.00 - 1.08；P = 0.042）。
ASC治疗KOA可改善短期临床结局。MRI结果，包括软骨损伤、BML和半月板挤出，与缓解率相关，有助于医生识别哪些患者可能从该治疗中获益。
