Abstract
BackgroundThe treatment of articular cartilage defects is a therapeutic challenge for orthopaedic surgeons. Furthermore, large osteochondral defects needs restoration of the underlying bone for sufficient biomechanical characteristics as well as the overlying cartilage.Case presentationA symptomatic large osteochondral defect in the knee joint was restored using a composite of umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) 0.5 x 107/ml and 4% hyaluronic acid (HA) hydrogel. Significant improvements in pain and function of the knee joint were identified by the evaluation at 12 months after surgery. A hyaline-like cartilage completely filled the defect and was congruent with the surrounding normal cartilage as revealed by magnetic resonance imaging (MRI), a second-look arthroscopy and histological assessment. The improved clinical outcomes maintained until 5.5 years. MRI also showed the maintenance of the restored bony and cartilaginous tissues.ConclusionThis case report suggests that the composite of allogeneic UCB-MSCs and HA hydrogel can be considered a safe and effective treatment option for large osteochondral defects of the knee.
Highlights
The treatment of articular cartilage defects is a therapeutic challenge for orthopaedic surgeons
This case report suggests that the composite of allogeneic Umbilical cord blood (UCB)-Mesenchymal stem cell (MSC) and hyaluronic acid (HA) hydrogel can be considered a safe and effective treatment option for large osteochondral defects of the knee
We previously reported that transplanting of UCBMSCs and hyaluronic acid hydrogel composite resulted in favorable cartilage repair in animal models [22,23,24,25,26]
Summary
The results of this study showed that the transplantation of the composite of UCB-MSCs and HA hydrogel can be a viable therapeutic option for the restoration of large osteochondral defects of the human joint. It can be performed through a one-stage arthroscopy assisted surgery with a small arthrotomy. The result of this case report warrants further studies on this novel therapeutic option
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