Y. Kim (Seoul, KR)
Yonsei Sarang Hospital Center for Stem Cell and Arthritis Research, Department of Orthopedic SurgeryPresenter Of 2 Presentations
16.3.10 - Comparison of Two Different Cartilage Repair Procedures with Concomitant High Tibial Osteotomy for Varus Knee Osteoarthritis
Abstract
Purpose
Cell-based tissue engineering approaches that use mesenchymal stem cells (MSCs) have addressed the issue of articular cartilage repair in knee osteoarthritis (OA). However, the most effective method of cartilage repair procedures has not been established. This study aimed to compare the clinical, radiological, and second-look arthroscopic outcomes related to two different cartilage repair procedures (implantation of MSCs or MSCs with allogenic cartilage) with concomitant high tibial osteotomy (HTO).
Methods and Materials
: Seventy patients treated with cartilage repair procedures and concomitant HTO were prospectively randomized into 2 groups: MSC implantation (MSC group), and implantation of MSCs with allogenic cartilage (MSC-AC group). Clinical outcomes were evaluated using the Lysholm Score and the Knee Injury and Osteoarthritis Outcome Score. Radiological outcomes were evaluated by measuring the femorotibial angle and posterior tibial slope. During second-look arthroscopy, cartilage regeneration was evaluated according to the Kanamiya grade.
Results
Clinical outcomes at the second-look arthroscopy improved significantly in both groups (P < 0.001 for all). Further improvement of clinical outcomes from the second-look arthroplasty to the final follow-up was observed only in the MSC-AC group (P < 0.05 for all). Overall, the Kanamiya grades, which were significantly correlated with clinical outcomes, were significantly higher in the MSC-AC group than in the MSC group. Radiological outcomes at final follow-up revealed improved knee joint alignments relative to preoperative conditions, but there was no significant correlation between clinical outcomes and Kanamiya grade in either group (P > 0.05 for all).
Conclusion
Implantation of MSCs with allogenic cartilage is superior to implantation of MSCs alone in cartilage regeneration accompanied with better clinical outcomes.
23.3.3 - Intra-articular Injection of Human Synovial Mesenchymal Stem Cells Promotes Cartilage Regeneration in a Canine Osteoarthritis Model
Abstract
Purpose
The purpose of this study is to evaluate the efficacy of human synovial mesenchymal stem cells (MSCs) for cartilage regeneration in surgical-induced osteoarthritis (OA) in Beagle dogs.
Methods and Materials
Sixty Beagle dogs underwent meniscal injury for OA models. Every intra-articular injection was performed at 4 weeks after knee injury. The dogs were divided into five groups (n = 12) according to the intra-articular injection materials: the sham group without injection (G1), the control group with phosphate-buffered saline (G2), the group with low dose MSCs (2.4 × 106 cells; G3), the group with medium dose MSCs (4.8 × 106 cells; G4), and the group with high dose MSCs (9.6 × 106 cells; G5). For evaluation of cartilage regeneration, histopathologic examinations that assessed the severity of cartilage damage, staining with Hematoxylin-eosin and Safranin-O, and analysis of immunohistochemistry (collagen type I and II) were used to document changes at time points of 6 or 24 weeks after injections.
Results
Severity of cartilage damage was significantly decreased in G3, G4, and G5 compared with G1 as well as G2 at both time points, and further improvements were observed at 24 weeks after injury compared with 6weeks after injury. Similar results were observed in staining with Hematoxylin-eosin and Safranin-O. Collagen composition of extracellular matrix (ECM) was more favorable in the G3, G4 and G5 than G1 as well as G2, and there were significant differences between groups (G3, G4 and G5); in other words, as the number of MSCs increased, more favorable results of collagen composition were observed. Further improvements in collagen composition were observed at 24 weeks after injury compared with 6weeks after injury.
Conclusion
Taken together, this study suggests that intra-articular injection of human synovial MSCs have a beneficial effect on OA via the chondrocyte proliferation and stimulation of ECM synthesis.