Cargando…
One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years
PURPOSE: The aim of this study is to prospectively evaluate the medium-term effectiveness and regenerative capability of autologous adult mesenchymal stem cells, harvested as bone marrow aspirate concentrate (BMAC), along with a hyaluronan-based scaffold (Hyalofast) in the treatment of ICRS grade 4...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548854/ https://www.ncbi.nlm.nih.gov/pubmed/26768608 http://dx.doi.org/10.1007/s00167-016-3984-6 |
_version_ | 1783255893332197376 |
---|---|
author | Gobbi, Alberto Scotti, Celeste Karnatzikos, Georgios Mudhigere, Abhishek Castro, Marc Peretti, Giuseppe M. |
author_facet | Gobbi, Alberto Scotti, Celeste Karnatzikos, Georgios Mudhigere, Abhishek Castro, Marc Peretti, Giuseppe M. |
author_sort | Gobbi, Alberto |
collection | PubMed |
description | PURPOSE: The aim of this study is to prospectively evaluate the medium-term effectiveness and regenerative capability of autologous adult mesenchymal stem cells, harvested as bone marrow aspirate concentrate (BMAC), along with a hyaluronan-based scaffold (Hyalofast) in the treatment of ICRS grade 4 chondral lesions of the knee joint, in patients older than 45 years. METHODS: A study group of 20 patients with an age >45 years (mean 50.0 ± 4.1 years) was compared to a control group of 20 patients with an age <45 years (mean 36.6 ± 5.0). Patients were prospectively evaluated for 4 years. All patients were evaluated with MRI, KOOS, IKDC, VAS and Tegner scores preoperatively and at two-year and final follow-up. RESULTS: At final follow-up, all scores significantly improved (P < 0.001) as follows: all KOOS score categories; Tegner 2 (range 0–4) to 6 (range 4–8) and 3 (range 0–6) to 6 (range 3–10); IKDC subjective (39.2 ± 16.5 to 82.2 ± 8.9) and (40.8 ± 13.9 to 79.4 ± 14.6), in the study and control group respectively. In addition, we show that results are affected by lesion size and number but not from concomitant surgical procedures. MRI showed complete filling in 80 % of patients in the study group and 71 % of patients in the control group. Histological analysis conducted in three patients from the study and two patients from the control group revealed good tissue repair with a variable amount of hyaline-like tissue. CONCLUSION: Treatment of cartilage lesions with BMAC and Hyalofast is a viable and effective option that is mainly affected by lesion size and number and not by age. In particular, it allows to address the >45 years population with functional outcomes that are comparable to younger patients at final follow-up. LEVEL OF EVIDENCE: Prospective cohort study, Level II. |
format | Online Article Text |
id | pubmed-5548854 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-55488542017-08-24 One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years Gobbi, Alberto Scotti, Celeste Karnatzikos, Georgios Mudhigere, Abhishek Castro, Marc Peretti, Giuseppe M. Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: The aim of this study is to prospectively evaluate the medium-term effectiveness and regenerative capability of autologous adult mesenchymal stem cells, harvested as bone marrow aspirate concentrate (BMAC), along with a hyaluronan-based scaffold (Hyalofast) in the treatment of ICRS grade 4 chondral lesions of the knee joint, in patients older than 45 years. METHODS: A study group of 20 patients with an age >45 years (mean 50.0 ± 4.1 years) was compared to a control group of 20 patients with an age <45 years (mean 36.6 ± 5.0). Patients were prospectively evaluated for 4 years. All patients were evaluated with MRI, KOOS, IKDC, VAS and Tegner scores preoperatively and at two-year and final follow-up. RESULTS: At final follow-up, all scores significantly improved (P < 0.001) as follows: all KOOS score categories; Tegner 2 (range 0–4) to 6 (range 4–8) and 3 (range 0–6) to 6 (range 3–10); IKDC subjective (39.2 ± 16.5 to 82.2 ± 8.9) and (40.8 ± 13.9 to 79.4 ± 14.6), in the study and control group respectively. In addition, we show that results are affected by lesion size and number but not from concomitant surgical procedures. MRI showed complete filling in 80 % of patients in the study group and 71 % of patients in the control group. Histological analysis conducted in three patients from the study and two patients from the control group revealed good tissue repair with a variable amount of hyaline-like tissue. CONCLUSION: Treatment of cartilage lesions with BMAC and Hyalofast is a viable and effective option that is mainly affected by lesion size and number and not by age. In particular, it allows to address the >45 years population with functional outcomes that are comparable to younger patients at final follow-up. LEVEL OF EVIDENCE: Prospective cohort study, Level II. Springer Berlin Heidelberg 2016-01-14 2017 /pmc/articles/PMC5548854/ /pubmed/26768608 http://dx.doi.org/10.1007/s00167-016-3984-6 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. |
spellingShingle | Knee Gobbi, Alberto Scotti, Celeste Karnatzikos, Georgios Mudhigere, Abhishek Castro, Marc Peretti, Giuseppe M. One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
title | One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
title_full | One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
title_fullStr | One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
title_full_unstemmed | One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
title_short | One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
title_sort | one-step surgery with multipotent stem cells and hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548854/ https://www.ncbi.nlm.nih.gov/pubmed/26768608 http://dx.doi.org/10.1007/s00167-016-3984-6 |
work_keys_str_mv | AT gobbialberto onestepsurgerywithmultipotentstemcellsandhyaluronanbasedscaffoldforthetreatmentoffullthicknesschondraldefectsofthekneeinpatientsolderthan45years AT scotticeleste onestepsurgerywithmultipotentstemcellsandhyaluronanbasedscaffoldforthetreatmentoffullthicknesschondraldefectsofthekneeinpatientsolderthan45years AT karnatzikosgeorgios onestepsurgerywithmultipotentstemcellsandhyaluronanbasedscaffoldforthetreatmentoffullthicknesschondraldefectsofthekneeinpatientsolderthan45years AT mudhigereabhishek onestepsurgerywithmultipotentstemcellsandhyaluronanbasedscaffoldforthetreatmentoffullthicknesschondraldefectsofthekneeinpatientsolderthan45years AT castromarc onestepsurgerywithmultipotentstemcellsandhyaluronanbasedscaffoldforthetreatmentoffullthicknesschondraldefectsofthekneeinpatientsolderthan45years AT perettigiuseppem onestepsurgerywithmultipotentstemcellsandhyaluronanbasedscaffoldforthetreatmentoffullthicknesschondraldefectsofthekneeinpatientsolderthan45years |