Purpose
The purpose of this study was to evaluate the clinical and imaging results of patients
who received intra-articular injections of autologous mesenchymal stem cells for the
treatment of knee osteoarthritis.
Methods
The study group comprised 18 patients (6 men and 12 women), among whom the mean age
was 54.6 years (range, 41 to 69 years). In each patient the adipose synovium was harvested
from the inner side of the infrapatellar fat pad by skin incision extension at the
arthroscopic lateral portal site after the patient underwent arthroscopic debridement.
After stem cells were isolated, a mean of 1.18 × 106 stem cells (range, 0.3 × 106 to 2.7 × 106 stem cells) were prepared with approximately 3.0 mL of platelet-rich plasma (with
a mean of 1.28 × 106 platelets per microliter) and injected into the selected knees of patients. Clinical
outcome was evaluated with the Western Ontario and McMaster Universities Osteoarthritis
Index, the Lysholm score, and the visual analog scale (VAS) for grading knee pain.
We also compared magnetic resonance imaging (MRI) data collected both preoperatively
and at the final follow-up.
Results
Western Ontario and McMaster Universities Osteoarthritis Index scores decreased significantly
(P < .001) from 49.9 points preoperatively to 30.3 points at the final follow-up (mean
follow-up, 24.3 months; range, 24 to 26 months). Lysholm scores also improved significantly
(P < .001) by the last follow-up visit, increasing from a mean preoperative value of
40.1 points to 73.4 points by the end of the study. Likewise, changes in VAS scores
throughout the follow-up period were also significant (P = .005); the mean VAS score decreased from 4.8 preoperatively to 2.0 at the last
follow-up visit. Radiography showed that, at the final follow-up point, the whole-organ
MRI score had significantly improved from 60.0 points to 48.3 points (P < .001). Particularly notable was the change in cartilage whole-organ MRI score,
which improved from 28.3 points to 21.7 points (P < .001). Further analysis showed that improvements in clinical and MRI results were
positively related to the number of stem cells injected.
Conclusions
The results of our study are encouraging and show that intra-articular injection of
infrapatellar fat pad–derived mesenchymal stem cells is effective for reducing pain
and improving knee function in patients being treated for knee osteoarthritis.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: January 31, 2013
Accepted:
November 13,
2012
Received:
July 14,
2012
Footnotes
Y-G.K. and S-B.J. contributed equally to this work.
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Mesenchymal Stem Cells Versus Fat Pad–Derived CellsArthroscopyVol. 30Issue 4
- PreviewWe read the article “Mesenchymal Stem Cell Injections Improve Symptoms of Knee Osteoarthritis” in the April 2013 issue of your highly acclaimed journal with great interest.1 We congratulate Koh et al. for their work, but we are very concerned about the erroneous use of the term “fat pad–derived mesenchymal stem cells (MSCs)” instead of “fat pad aspirate concentrate” or “fat pad–derived cells” (probably containing a small number of mesenchymal stem cells) in the article. It leads to serious confusion for the readers including ourselves.
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