Allogeneic umbilical cord blood-derived mesenchymal stem cells combined with high tibial osteotomy: a retrospective stud
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ORIGINAL PAPER
Allogeneic umbilical cord blood-derived mesenchymal stem cells combined with high tibial osteotomy: a retrospective study on safety and early results Young-Woo Chung 1 & Hong-Yeol Yang 2 & Sung-Ju Kang 2 & Eun-Kyoo Song 2 & Jong-Keun Seon 2 Received: 7 May 2020 / Accepted: 9 October 2020 # SICOT aisbl 2020
Abstract Background Cartilage repair performed as a single-stage procedure is an important advancement in the treatment of fullthickness cartilage injury and has potential for widespread clinical use. Purpose To investigate the short-term outcomes and cartilage regeneration after implantation of allogeneic human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in patients who received high tibial osteotomy (HTO) for symptomatic medial knee osteoarthritis. Methods Patients underwent treatment of full-thickness chondral injury in the osteoarthritic knee with HTO and implantation of hUCB-MSCs and were followed prospectively for a minimum of one year. Ninety-three patients were followed for a mean 1.7 years (range, 1.0–3.5). Median cartilage lesion size was 6.5 cm2 (range, 2.0–12.8). Clinical outcomes were examined with patient-reported scoring instruments that consisted of the International Knee Documentation Committee (IKDC) subjective score, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, Knee Society Score (KSS), and Hospital for Special Surgery (HSS) score. Cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) cartilage repair assessment grading (CRA) system and the Koshino regeneration staging system in 49 patients who underwent second look arthroscopic assessment when their HTO plates were removed. Results At final follow-up, the median IKDC subjective score had significantly improved from 39.0 to 71.3; the WOMAC score from 44.5 to 11.0; the KSS pain and function scores from 29.8 to 43.2 and 61.0 to 81.2, respectively; and the HSS from 61.6 to 82.7 (p < 0.05). Pre-operative examination showed ICRS grade IV cartilage injury in all knees, and cartilage regeneration at 2nd look arthroscopy showed improvements (8.2% of patients improved to ICRS grade I, 69.3% to grade II, and 22.5% to grade III). Moreover, Koshino stage was B in 24.5% and C in 75.5% of patients (p < 0.05). Conclusion Allogeneic hUCB-MSC implantation combined with HTO for medial knee osteoarthritis was safe and showed signs of cartilage status improvement. Furthermore, randomized controlled studies with a control group are necessary to determine the real effectiveness and indications of this new combined procedure for patients with osteoarthritis. Keywords Knee . Articular cartilage . Umbilical cord blood . Stem cell therapy . Osteotomy
Introduction Young-Woo Chung and Hong-Yeol Yang contributed equally to this work. Level of evidence: 4 * Jong-Keun Seon [email protected] 1
Department of Orthopedic Surgery, Gwangju Veterans Hospital, Gwangju, Republic of Korea
2
Center for Joint Disease, Chonnam National University Bitgoeul Hospital, 80, Deoknamg
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