BM-MSCs differentiated to chondrocytes for treatment of full-thickness cartilage defect of the knee

BM-MSCs 分化为软骨细胞治疗膝关节全层软骨缺损

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作者:Rodrigo Mardones, Alessio Giai Via, Gennaro Pipino, Claudio M Jofre, Sara Muñoz, Edgar Narvaez, Nicola Maffulli

Background

Full-thickness articular cartilage injury of the knee is a major cause of disability. The

Conclusion

The treatment of full-thickness chondral injuries of the knee with differentiated to chondrocytes BM-MSCs and Chondro-Gide® scaffold showed encouraging outcomes. Further studies involving more patients, and with longer follow-up, are required to evaluate the effectiveness of the treatment and the long-term results.

Methods

Fifteen patients (19 knees) with symptomatic full-thickness cartilage defects of the knee were enrolled. Bone marrow was harvested from the iliac crest, BM-MSCs were prepared, and expanded cells were grown in a standard medium or in a standard culture medium containing TGF-β. BM-MSCs differentiated to chondrocytes were seeded in a porcine collagen type I/III scaffold (Chondro-Gide®) and cultured in TGF-β containing media. After 4 weeks, the membrane was sutured on the cartilage defect. All patients underwent plain radiographs (antero-posterior, lateral, and axial view of the patella) and MRI of the affected knee. The Oxford knee score, the Lyhsolm scale, and the VAS score were administered to all patients. At final follow-up a MRI for the study of articular cartilage was undertaken.

Results

The mean size of the cartilage lesions was 20 × 17 mm (range, 15 × 10 mm-30 × 30 mm). At final follow-up, the median Oxford knee score and Lyhsolm scale scores significantly improved from 29 (range 12-39; SD 7.39) to 45 (range 24-48; SD 5.6) and from 55.5 (range 25-81; SD 17.7) to 94.5 (58-100; SD 10.8), respectively. Pain, according to the VAS score, significantly improved. Sixty percent of patients reported their satisfaction as excellent, 20% as good, 14% as fair, and 1 patient as poor.

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