The Effects of Autologous Stem Cells from Bone Marrow and Adipose Tissue on Patients with Knee Osteoarthritis

Abstract

Osteoarthritis (OA) of the knee joint, the most common form of knee arthritis, is the gradual degeneration of joint cartilage. A progression of OA is characterized by the degradation and degeneration of the articular cartilage with subchondral bone remodeling, osteophyte formation and inflammation leading to bone-on-bone contact causing pain, stiffness, and functional difficulties and disability. OA affects the patient’s quality of life and creates a significant financial burden on the health care system. This retrospective study collected data from patients who received autologous MSCs injections of bone marrow aspirate concentrate (BMAC) and/or micro-fragmented adipose tissue (MFAT). Data from patient-reported outcomes (PROs) were collected pre-treatment and at post-treatment follow-ups and correspondences. Surveys distributed included Visual Analog Scale (VAS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR), and a patient satisfaction survey. Out of 151 patients that met clinical criteria, 103 patients (159 knees) had appropriate follow up data. Of the 103 patients, 25 patients had knee arthroscopy prior to stem cell injection. 63 patients received platelet-rich plasma (PRP) injections within 12 months and five patients had conversion to Total Knee Arthroplasty (TKA). BMAC, MFAT graft, and BMAC and MFAT graft groups showed significant improvement in both VAS and KOOS, JR between baseline and 3,6,12, and 24 months post-treatment (p<0.00001). Among BMAC only patients, KL grade breakdown showed significant improvement in VAS and KOOS, JR scores within 24 months post-treatment across all grades (2-4).