Purpose

Bone marrow derived mesenchymal stem cell transplantation is a novel surgical technique in the management of osteochondral defects, with the potential fro cartilage regeneration. The aim of this study was to demonstrate the 2 year outcomes of this intervention.

Methods and Materials

114 patients between the ages of 15-55 who had MRI diagnosed full thickness osteochondral defects in the knee were included. Patients were prospectively reviewed at 6, 12 and 24 months with a repeat MRI scan at 2 years. Visual analogue score (VAS), Cincinatti and EQ5D (tto, VAS) were noted at each time point. Linear regression and paired t-tests were utilised for data analyses.

Results

110 patients were included in the analysis with 4 patients lost to follow-up. The average age of patients was 29 (15-50), 75 males and 35 females. Table 1 demonstrates significant improvement in outcome scores in all outcomes except the EQ-5D at 2 years.

Graph 1 depicts improved outcome scores at each interval . Age and size of defect were independent risk factors for poor outcomes with those under 30 and with defects smaller than 400mm² having significant improvements in their VAS, Cincinnati, and EQ VAS scores (P<0.05) at 2 years as opposed to older patients and those with larger defects. MR imaging indicating successful graft incorporation was associated with significant improvement in all outcome scores P<0.05 with 79% of patients demonstrating more than 50% regeneration of hyaline like cartilage.

Conclusion

This study is the first to demonstrate clinical and radiological improvement in those patients undergoing surgery with bone marrow derived stem cells at 2 years for osteochondral defects around the knee.