Ultrasound-guided intra-articular injection of expanded umbilical cord mesenchymal stem cellsin knee osteoarthritis: a safety/efficacy study with MRI data.

Abstract

Aim: This study has the primary objective of studying the effect of Wharton jelly mesenchymal stem cells (WJMSCs) in the treatment of knee osteoarthritis. As asecondary end point, we report on theefficacy of such therapy. Patients and methods: 16patients with advanced Kellgren stage were treated using two doses of expanded WJMSCs given 1 month apart. Patients were followed for 48months using theKnee Injury and Osteoarthritis Outcome Score (KOOS)and 12months using magnetic resonance imaging (MRI). Results: Treatment was well tolerated. One patient developed moderate effusion and one superficial phlebitis. We observed functional and pain improvement at 12 and 48months (p<0.0001), with statistically significant improvement on MRI scansat 12months in cartilage loss, osteophytes, bone marrow lesions, effusion and synovitis (p<0.01), and highly significant improvement in subchondral sclerosis (p<0.0001). Conclusion: WJMSCs are safe and potentially effective in producing significant improvement in KOOS and MRI scores when administered intra-articularly in knee osteoarthritis cases under ultrasound guidance.