Intra-articular Injection of Mesenchymal Stem Cells for the Treatment of Osteoarthritis of the Knee

                                                                                        

Intra-articular Injection of Mesenchymal Stem Cells for the Treatment of Osteoarthritis of the Knee: A 2-Year Follow-up Study.

 
This well-performed comparison study supports my 4-year clinical impression of own stem cell/MSC use:
    - better results using a higher-concentration of stem cells
    - excellent pain relief for up to two years.
- K Cunningham MD

BACKGROUND:

The intra-articular injection of mesenchymal stem cells (MSCs) into the knee has shown a potential for the treatment of generalized cartilage loss in osteoarthritis (OA). However, there have been few midterm reports with clinical and structural outcomes.

PURPOSE:

To assess the midterm safety and efficacy of an intra-articular injection of autologous adipose tissue-derived (AD) MSCs for knee OA at 2-year follow-up.

STUDY DESIGN:

Cohort study; Level of evidence, 3.

METHODS:

Eighteen patients with OA of the knee were enrolled (3 male, 15 female; mean age, 61.8 ± 6.6 years [range, 52-72 years]). Patients in the low-, medium-, and high-dose groups received an intra-articular injection of 1.0 × 107, 5.0 × 107, and 1.0 × 108 AD MSCs into the knee, respectively. Clinical and structural evaluations were performed with widely used methodologies including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and measurements of the size and depth of the cartilage defect, signal intensity of regenerated cartilage, and cartilage volume using magnetic resonance imaging (MRI).

RESULTS:

There were no treatment-related adverse events during the 2-year period. An intra-articular injection of autologous AD MSCs improved knee function, as measured with the WOMAC, KneeSociety clinical rating system (KSS), and Knee injury and Osteoarthritis Outcome Score (KOOS), and reduced knee pain, as measured with the visual analog scale (VAS), for up to 2 years regardless of the cell dosage. However, statistical significance was found mainly in the high-dose group. Clinical outcomes tended to deteriorate after 1 year in the low- and medium-dose groups, whereas those in the high-dose group plateaued until 2 yearsThe structural outcomes evaluated with MRI also showed similar trends.

CONCLUSION:

This study identified the safety and efficacy of an intra-articular injection of AD MSCs into the OA knee over 2 years, encouraging a larger randomized clinical trial. However, this study also showed potential concerns about the durability of clinical and structural outcomes, suggesting the need for further studies.

CLINICAL TRIAL REGISTRATION: NCT01300598.

KEYWORDS: intra-articular injectionkneemesenchymal stem cell; osteoarthritis

PMI 28746812

2017 Oct;45(12):2774-2783. doi: 10.1177/0363546517716641. Epub 2017 Jul 26. 

 Jo CH1Chai JW2Jeong EC3Oh S4Shin JS1Shim H5Yoon KS1.

*This publication was not written by Dr. Kelly Cunningham but by the authors above. 

If you have any questions, please call 512.410.0767 Monday - Friday or make an appointment with Dr. Cunningham today! We are located at 3003 Bee Cave Rd Suite 200, Austin Texas 

Author
Dr. Kelly Cunningham Physician

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