In step with contemporary trends-stem-celltherapy as a key driver of regenerative orthopedics at the Clinical Center of Vojvodina - preliminary data for the treatment of knee osteoarthritis and osteochondral lesions

Abstract

Introduction. In the treatment of various orthopedic conditions, regenerativetherapies, including platelet rich plasma and autologous stem-cell therapy, have recently been advancing. Knee cartilage lesions are a debilitating disease resulting in fibrillation and subsequent degradation which can also involve the subchondral bone and lead to the development of osteoarthritis. Bone marrow mesenchymal stem cells are a heterogeneous mixture of cells involved in cartilage formation and regenerative repair, whereas other mesenchymal stem cells have the capacity to play a role as immunomodulatory and trophic factors. Nowadays, stem-cell therapy is widely used for the treatment of knee osteoarthritis and cartilage lesions. The purpose of this study was to evaluate preliminary clinical data of treatment of knee osteoarthritis with stem cell injection and treatment of osteochondral lesions with stem-cell scaffold. Material and Methods. Stem cells were obtained by concentrating the content taken with aspiration needles from the bone marrow my means of Arthrex Angel Bone Marrow Aspirate Concentrate centrifuge. Results. The study sample consisted of 39 patients who were included in knee osteoarthritis treatment. Surgical implantation was performed in 7 patients from the osteochondral group. In the first group, an average Visual Analogue Scale pain felt before intervention decreased statistically significantly three days after the intervention (from 7.27 to 2.12, p?0.05) and remained 1.2 until the check-up after 3 months. The same results were achieved in the average Western Ontario and McMaster Universities Arthritis Index score (prior to intervention = 51.5; after 1 month = 72 and after 3 months = 76). For the second group, an average preintervention Visual Analogue Scale pain decreased statistically significantly three days after intervention (from 8.1 to 2.7) and remained 1.2 until the check-up after months. The same results were achieved on the Knee injury and Osteoarthritis Outcome Score pain (p?0.05). Both procedures were proved as safe providing pain relief and function improvement of treated knee joints.