Abstract
BackgroundA prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD).Case presentationAfter failed conventional management of OCD a patient undergoes intra-articular MSC therapy. Patient outcome measures included the Numeric Pain Rating Scale (NPRS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Structural outcome was assessed using MRI with the novel technique of T2 mapping used to indicate cartilage quality. Following MSC therapy the patient reported improvement in pain and function as measured by NPRS, WOMAC and KOOS. Repeat MRI analysis showed regeneration of cartilage. MRI T2 mapping indicated hyaline like cartilage regrowth.ConclusionIn this report, the use of MSCs, after unsuccessful conventional OCD management, resulted in structural, functional and pain improvement. These results highlight the need to further study the regenerative potential of MSC therapy.Trial registrationAustralian and New Zealand Clinical Trial Registry Number - ACTRN12615000258550 (Date registered 19/03/2015 – retrospectively registered).
Highlights
IntroductionA prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD)
A prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD).Case presentation: After failed conventional management of OCD a patient undergoes intra-articular mesenchymal stem cells (MSCs) therapy
In this report, the use of MSCs, after unsuccessful conventional OCD management, resulted in structural, functional and pain improvement. These results highlight the need to further study the regenerative potential of MSC therapy
Summary
A prospective analysis of the effect of autologous adipose derived mesenchymal stem cell (MSC) therapy in the treatment of an osteochondral defect of the knee with early progressive osteoarthritis following unsuccessful surgical intervention of osteochondritis dissecans (OCD). Case presentation: After failed conventional management of OCD a patient undergoes intra-articular MSC therapy. Following MSC therapy the patient reported improvement in pain and function as measured by NPRS, WOMAC and KOOS. MRI T2 mapping indicated hyaline like cartilage regrowth. Whilst the pathophysiology of OCD remains uncertain, it is accepted that it is a subchondral lesion characterized by variable degrees of bone resorption, collapse, sequestration and overlying articular cartilage disruption [2, 3]. OCD was initially termed osteochondritis due to a belief that it resulted from an inflammatory process [4]. Repetitive microtrauma has become an accepted preceding stimulus due to the observed increased incidence of OCD amongst the athletic population [5,6,7]
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