Skip to main content
Erschienen in: International Orthopaedics 1/2019

03.10.2018 | Original Paper

Preliminary results of autologous adipose-derived stem cells in early knee osteoarthritis: identification of a subpopulation with greater response

verfasst von: Alfredo Schiavone Panni, Michele Vasso, Adriano Braile, Giuseppe Toro, Annalisa De Cicco, Davide Viggiano, Federica Lepore

Erschienen in: International Orthopaedics | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to report the clinical and functional results of a series of patients with early knee osteoarthritis (KOA) treated with the intra-articular injection of autologous adipose-derived stem cells (aASCs) plus arthroscopic debridement. The hypothesis was that protocol would significantly improve the clinical and functional outcomes in patients with early KOA.

Methods

Fifty-two patients with early KOA, who received arthroscopic debridement followed by percutaneous injection of aASCs, were enrolled into the study and retrospectively analyzed with an average follow-up of 15.3 (range, 6 to 24) months. Patients were assessed through the IKS knee and function scores and VAS pain scale.

Results

The mean IKS knee score improved from 37.4 (range, 14 to 79) points pre-operatively to 62.6 (range, 27 to 95) points at the latest follow-up (p < < 0.01). The mean IKS function score improved from 57.2 (range, 25 to 100) points pre-operatively to 83.0 (range, 35 to 100) points at the latest follow-up (p < < 0.01). The mean VAS score decreased from 8.5 (range, 3 to 10) pre-operatively to 5.1 (range, 0 to 8) at the latest follow-up (p < < 0.01). Additionally, patients with a pre-operative VAS score greater than 8 were found to show greater clinical and functional benefits compared with patients with VAS score lower than 8.

Conclusions

The knee injection of aASCs associated to arthroscopic debridement increased significantly the clinical and functional scores in patients with early KOA at a mid-term follow-up, especially those with higher pre-operative VAS scores.
Literatur
1.
Zurück zum Zitat Hudetz D, Borić I, Rod E, Jeleč Ž, Radić A, Vrdoljak T, Skelin A, Lauc G, Trbojević-Akmačić I, Plečko M, Polašek O, Primorac D (2017) The effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis. Genes (Basel) 13;8(10):270 Hudetz D, Borić I, Rod E, Jeleč Ž, Radić A, Vrdoljak T, Skelin A, Lauc G, Trbojević-Akmačić I, Plečko M, Polašek O, Primorac D (2017) The effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis. Genes (Basel) 13;8(10):270
2.
Zurück zum Zitat Duymus TM, Mutlu S, Dernek B, Komur B, Aydogmus S, Kesiktas FN (2017) Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc 25:485–492CrossRefPubMed Duymus TM, Mutlu S, Dernek B, Komur B, Aydogmus S, Kesiktas FN (2017) Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc 25:485–492CrossRefPubMed
3.
Zurück zum Zitat Khoshbin A, Leroux T, Wasserstein D, Marks P, Theodoropoulos J, Ogilvie-Harris D, Gandhi R, Takhar K, Lum G, Chahal J (2013) The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Arthroscopy 29:2037–2048CrossRefPubMed Khoshbin A, Leroux T, Wasserstein D, Marks P, Theodoropoulos J, Ogilvie-Harris D, Gandhi R, Takhar K, Lum G, Chahal J (2013) The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Arthroscopy 29:2037–2048CrossRefPubMed
4.
Zurück zum Zitat Orchard J, Moen MH (2017) Has reimbursement for knee osteoarthritis treatments now reached ‘postfact’ status? Br J Sports Med 51:1510–1511CrossRefPubMed Orchard J, Moen MH (2017) Has reimbursement for knee osteoarthritis treatments now reached ‘postfact’ status? Br J Sports Med 51:1510–1511CrossRefPubMed
6.
Zurück zum Zitat Cuti T, Antunovic M, Marijanovic I, Ivkovic A, Vukasovic A, Matic I, Pecina M, Hudetz D (2017) Capacity of muscle derived stem cells and pericytes to promote tendon graft integration and ligamentization following anterior cruciate ligament reconstruction. Int Orthop 41:1189–1198CrossRefPubMed Cuti T, Antunovic M, Marijanovic I, Ivkovic A, Vukasovic A, Matic I, Pecina M, Hudetz D (2017) Capacity of muscle derived stem cells and pericytes to promote tendon graft integration and ligamentization following anterior cruciate ligament reconstruction. Int Orthop 41:1189–1198CrossRefPubMed
7.
Zurück zum Zitat Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, Sensebe L, Casteilla L, Fleury S, Bourin P, Noël D, Canovas F, Cyteval C, Lisignoli G, Schrauth J, Haddad D, Domergue S, Noeth U, Jorgensen C, ADIPOA Consortium (2016) Adipose mesenchymal stromal cell-based therapy for severe osteoarthritis of the knee: a phase I dose-escalation trial. Stem Cells Transl Med 5:847–856CrossRefPubMedPubMedCentral Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, Sensebe L, Casteilla L, Fleury S, Bourin P, Noël D, Canovas F, Cyteval C, Lisignoli G, Schrauth J, Haddad D, Domergue S, Noeth U, Jorgensen C, ADIPOA Consortium (2016) Adipose mesenchymal stromal cell-based therapy for severe osteoarthritis of the knee: a phase I dose-escalation trial. Stem Cells Transl Med 5:847–856CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Adriani E, Moio M, Di Paola B, Salustri W, Alfieri A, Parisi P, Ruggiero M, Borab Z, Carlesimo B (2017) Percutaneous fat transfer to treat knee osteoarthritis symptoms: preliminary results. Joints 5:89–92CrossRefPubMedPubMedCentral Adriani E, Moio M, Di Paola B, Salustri W, Alfieri A, Parisi P, Ruggiero M, Borab Z, Carlesimo B (2017) Percutaneous fat transfer to treat knee osteoarthritis symptoms: preliminary results. Joints 5:89–92CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A (2006) Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint. Am J Roentgenol 187:794–799CrossRef Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A (2006) Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint. Am J Roentgenol 187:794–799CrossRef
11.
Zurück zum Zitat Misso ML, Pitt VJ, Jones KM, Barnes HN, Piterman L, Green SE (2008) Quality and consistency of clinical practice guidelines for diagnosis and management of osteoarthritis of the hip and knee: a descriptive overview of published guidelines. Med J Aust 189:394–399PubMed Misso ML, Pitt VJ, Jones KM, Barnes HN, Piterman L, Green SE (2008) Quality and consistency of clinical practice guidelines for diagnosis and management of osteoarthritis of the hip and knee: a descriptive overview of published guidelines. Med J Aust 189:394–399PubMed
12.
Zurück zum Zitat Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C (2013) A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 22:2063–2077CrossRefPubMed Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C (2013) A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 22:2063–2077CrossRefPubMed
13.
Zurück zum Zitat Schiavone Panni A, Del Regno C, Mazzitelli G, D’Apolito R, Corona K, Vasso M (2017) Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4503-0 Schiavone Panni A, Del Regno C, Mazzitelli G, D’Apolito R, Corona K, Vasso M (2017) Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc. https://​doi.​org/​10.​1007/​s00167-017-4503-0
14.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14 Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14
15.
Zurück zum Zitat Cui GH, Wang YY, Li CJ, Shi CH, Wang WS (2016) Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: a meta-analysis. Exp Ther Med 12:3390–3400CrossRefPubMedPubMedCentral Cui GH, Wang YY, Li CJ, Shi CH, Wang WS (2016) Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: a meta-analysis. Exp Ther Med 12:3390–3400CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Jo CH, Chai JW, Jeong EC, Oh S, Shin JS, Shim H, Yoon KS (2017) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a 2-year follow-up study. Am J Sports Med 45:2774–2783CrossRefPubMed Jo CH, Chai JW, Jeong EC, Oh S, Shin JS, Shim H, Yoon KS (2017) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a 2-year follow-up study. Am J Sports Med 45:2774–2783CrossRefPubMed
17.
Zurück zum Zitat Krüger JP, Freymannx U, Vetterlein S, Neumann K, Endres M, Kaps C (2013) Bioactive factors in platelet-rich plasma obtained by apheresis. Transfus Med Hemother 40:432–440CrossRefPubMedPubMedCentral Krüger JP, Freymannx U, Vetterlein S, Neumann K, Endres M, Kaps C (2013) Bioactive factors in platelet-rich plasma obtained by apheresis. Transfus Med Hemother 40:432–440CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Pak J, Lee JH, Park KS, Jeong BC, Lee SH (2016) Regeneration of cartilage in human knee osteoarthritis with autologous adipose tissue-derived stem cells and autologous extracellular matrix. Biores Open Access 5:192–200CrossRefPubMedPubMedCentral Pak J, Lee JH, Park KS, Jeong BC, Lee SH (2016) Regeneration of cartilage in human knee osteoarthritis with autologous adipose tissue-derived stem cells and autologous extracellular matrix. Biores Open Access 5:192–200CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Grieshober JA, Stanton M, Gambardella R (2016) Debridement of articular cartilage: the natural course. Sports Med Arthrosc Rev 24:56–62CrossRefPubMed Grieshober JA, Stanton M, Gambardella R (2016) Debridement of articular cartilage: the natural course. Sports Med Arthrosc Rev 24:56–62CrossRefPubMed
21.
Zurück zum Zitat Katz JN, Brownlee SA, Jones MH (2014) The role of arthroscopy in the management of knee osteoarthritis. Best Pract Res Clin Rheumatol 28:143–156CrossRefPubMedPubMedCentral Katz JN, Brownlee SA, Jones MH (2014) The role of arthroscopy in the management of knee osteoarthritis. Best Pract Res Clin Rheumatol 28:143–156CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M, Seil R (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 25:335–346CrossRefPubMedPubMedCentral Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M, Seil R (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 25:335–346CrossRefPubMedPubMedCentral
Metadaten
Titel
Preliminary results of autologous adipose-derived stem cells in early knee osteoarthritis: identification of a subpopulation with greater response
verfasst von
Alfredo Schiavone Panni
Michele Vasso
Adriano Braile
Giuseppe Toro
Annalisa De Cicco
Davide Viggiano
Federica Lepore
Publikationsdatum
03.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 1/2019
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4182-6

Weitere Artikel der Ausgabe 1/2019

International Orthopaedics 1/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.