Giusti Simone, Adriani Ezio, Samuelsson Kristian, Laudisio Alice, Horvath Alexandra, Zampogna Biagio, Papalia Rocco
Unita Operativa Complessa di Traumatologia dello Sport e Chirurgia Articolare Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy.
Operative Research Unit of Orthopaedic and Trauma Surgery Fondazione Policlinico Universitario Campus Bio-Medico Rome Italy.
J Exp Orthop. 2025 Jul 21;12(3):e70368. doi: 10.1002/jeo2.70368. eCollection 2025 Jul.
To determine the difference in clinical scores and re-intervention rates in patients receiving intra-articular adipose-derived mesenchymal stromal cells (AD-MSCs) as a stand-alone treatment for knee osteoarthritis (OA) compared to patients receiving the same treatment following arthroscopic debridement and lavage.
Internal records at two orthopaedic centres were reviewed, and all consecutive patients with Kellgren-Lawrence II-III knee OA who had received intra-articular AD-MSC during 2017-2018 were included. The patients were stratified into two cohorts depending on whether they also received debridement arthroscopy. Patients were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) scores as well as re-intervention rates with a last available follow-up of 5 years after the intra-articular AD-MSC injection.
A total of 135 patients were enroled, 66 (49%) patients were male and 69 (51%) were female. The mean age at the time of intervention was 66 (range: 43-81) years. About half of the cohort ( = 68) received a diagnostic and therapeutic arthroscopy (intervention) procedure in the same setting, whereas the other half ( = 67) received intra-articular AD-MSCs without an arthroscopic procedure (control). Totally, 94% reported improved VAS scores post-operatively. Seventy-two patients (53%) had good symptomatic control at 5 years after the intra-articular AD-MSCs injection (VAS score range 0-3). Within this group, 57% of the patients had also received arthroscopy as part of their treatment, whereas the remaining patients had only received the intra-articular injection of AD-MSCs. Overall, WOMAC (46 arthroscopy + AD-MSC, 58 AD-MSC, < 0.0001) and functionality (34 arthroscopy + AD-MSC, 43 AD-MSC, < 0.0001) scores were superior in the cohort who also received debridement arthroscopy at the 5-year follow-up. Conservative re-intervention rates, such as hyaluronic acid injections, were comparable amongst the cohorts.
Overall, debridement arthroscopy with AD-MSC is favoured over stand-alone MSC in Kellgren-Lawrence I-III knee OA.
Level III, retrospective comparative study.
确定接受关节内注射脂肪来源间充质基质细胞（AD-MSCs）作为膝关节骨关节炎（OA）单一治疗的患者与接受关节镜清理和灌洗后再接受相同治疗的患者在临床评分和再次干预率方面的差异。
回顾了两个骨科中心的内部记录，纳入了2017年至2018年期间所有连续接受关节内AD-MSC治疗的Kellgren-Lawrence II-III级膝关节OA患者。根据患者是否还接受了关节镜清理术，将患者分为两个队列。采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和视觉模拟量表（VAS）评分对患者进行评估，并在关节内注射AD-MSC后进行5年的末次随访，统计再次干预率。
共纳入135例患者，其中男性66例（49%），女性69例（51%）。干预时的平均年龄为66岁（范围：43 - 81岁）。约一半的队列（n = 68）在同一时间接受了诊断性和治疗性关节镜检查（干预），而另一半（n = 67）接受了关节内AD-MSCs注射但未进行关节镜检查（对照）。总体而言，94%的患者术后VAS评分有所改善。72例（53%）患者在关节内注射AD-MSCs后5年症状得到良好控制（VAS评分范围0 - 3）。在该组中，57%的患者还接受了关节镜检查作为治疗的一部分，但其余患者仅接受了关节内AD-MSCs注射。总体而言，在5年随访时，接受关节镜清理术的队列中，WOMAC评分（关节镜检查 + AD-MSC组46例，AD-MSC组58例，P < 0.0001）和功能评分（关节镜检查 + AD-MSC组34例，AD-MSC组43例，P < 0.0001）更高。保守治疗的再次干预率，如透明质酸注射，在各队列中相当。
总体而言，在Kellgren-Lawrence I-III级膝关节OA中，关节镜清理术联合AD-MSC治疗优于单纯AD-MSC治疗。
III级，回顾性比较研究。
