K. Shimomura (Osaka, JP)Osaka University Graduate School of Medicine Department of Orthopaedic Surgery
Presenter Of 1 Presentation
P241 - Five-year Outcome of a Scaffold-free Mesenchymal Stem Cell-based Tissue-engineered Construct for Repair of Knee Chondral Lesions
We have originally developed a scaffold-free tissue-engineered construct (TEC) derived from autologous synovial membrane mesenchymal stem cells (MSCs) and demonstrated their safety and efficacy for cartilage repair at 2 years postoperatively in our earlier study. The aim of this study was to investigate the clinical outcomes and MRI findings of the TEC for the treatment of injured articular cartilage at midterm.
Methods and Materials
An observational first-in-human study limited to 5 cases was approved by the Ministry of Health, Labor, and Welfare of Japan. Five patients (age 28 - 46 years old) with symptomatic knee chondral lesions (1.5 - 3.0 cm2) on the medial femoral condyle, lateral femoral condyle, or femoral groove were enrolled in this study. Synovial MSCs were isolated from arthroscopic biopsy specimens and cultured to develop a TEC. The TECs were then implanted into chondral defects without fixation and assessed up to 5 years postoperatively. We clinically evaluated the patients using visual analog scale (VAS), Lysholm, Tegner, and Knee injury and Osteoarthritis Outcome Score (KOOS) scores. An MRI evaluation was performed for morphologic and compositional quality of the repair tissue at 5 years of follow-up.
All clinical scores were significantly improved from the preoperative evaluation to the 2- and 5-year follow-ups, and the results were stable over time (figure 1). The MRI evaluation showed cartilage defects filled with newly generated tissues over time, and the repair tissue exhibited good tissue integration with adjacent host cartilage (figure 2). The cartilage thickness and surface smoothness of the repair cartilage were maintained out to 5 years postoperatively.
The present results highlighted the efficacy and feasibility of this procedure, showing stable clinical outcomes and MRI findings at midterm follow-up. Thus, autologous scaffold-free TEC derived from synovial MSCs could be used for regenerative cartilage repair via a sutureless and simple implantation procedure.