Allogenic Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells Are More Effective Than Bone Marrow Aspiration Concentrate for Cartilage Regeneration After High Tibial Osteotomy in Medial Unicompartmental Osteoarthritis of Knee

Lee, Nam-Hun; Na, Seung-Min; Ahn, Hyeon-Wook; Kang, Joon-Kyoo; Seon, Jong Keun; Song, Eun-Kyoo

doi:10.1016/j.arthro.2021.02.022

Cited by 38 publications

(79 citation statements)

References 32 publications

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“…However, second-look arthroscopy showed better healing of repaired cartilage in the UC-MSCs group. Similar results were obtained in a recent retrospective study of 150 cases that underwent HTO with MFX combined with BMAC or allogeneic UC-MSCs procedure for medial unicompartmental OA [ 120 ]. A total of 123 cases underwent plate removal and second-look arthroscopy after a minimum of 1 year after the HTO surgery.…”

Section: Clinical Perspectivesupporting

confidence: 87%

Cell Sources for Cartilage Repair—Biological and Clinical Perspective

Urlić

Ivković

2021

Cells

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Cell-based therapy represents a promising treatment strategy for cartilage defects. Alone or in combination with scaffolds/biological signals, these strategies open many new avenues for cartilage tissue engineering. However, the choice of the optimal cell source is not that straightforward. Currently, various types of differentiated cells (articular and nasal chondrocytes) and stem cells (mesenchymal stem cells, induced pluripotent stem cells) are being researched to objectively assess their merits and disadvantages with respect to the ability to repair damaged articular cartilage. In this paper, we focus on the different cell types used in cartilage treatment, first from a biological scientist’s perspective and then from a clinician’s standpoint. We compare and analyze the advantages and disadvantages of these cell types and offer a potential outlook for future research and clinical application.

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Section: Clinical Perspectivesupporting

confidence: 87%

Cell Sources for Cartilage Repair—Biological and Clinical Perspective

Urlić

Ivković

2021

Cells

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“…Thus, it is only fair that implanted MSCs and other reparative procedures be evaluated separately from injected orthobiologics as it would be expected that reparative procedures lead to far better macroscopic outcomes. Regardless, the absolute outcomes reported by Lee et al [24] and Yang et al [25] regarding injected MSCs remained acceptable when compared to other studies in this review. However, the authors do report discordance between macroscopic outcomes (ICRS-CRA, Koshino) and clinical findings (IKDC, KOOS, Lysholm, WOMAC, VAS, Tegner, KSS).…”

Section: Discussionmentioning

confidence: 52%

“…This systematic review aimed to qualitatively evaluate the current evidence reporting outcomes of intra-articular injection of orthobiologics in patients undergoing HTO for OA of the knee. The key finding reported in this study is that there is a significant improvement in cartilage repair and regeneration following HTO when a concomitant injected orthobiologic product is used, except in studies when the injected orthobiologic is compared to an intervention utilising implanted MSC such as in the studies conducted by Yang et al [25] and Lee et al [24]. In our systematic review, we excluded implanted MSCs due to the nature of the procedure being reparative as compared to injected orthobiologics which are considered regenerative procedures.…”

Section: Discussionmentioning

confidence: 72%

“…Among the included studies reporting data on injected MSCs, Kim et al [23] was the only study that reported ICRS-CRA, with significant improved outcomes in the intervention group, in line with significant clinical outcomes according to IKDC and Lysholm scoring. In contrast, BMAC studies present a mismatch between macroscopic and clinical outcomes, with three studies [15,24,25] reporting significant macroscopic but insignificant clinical outcomes. This can be attributed to high levels of heterogeneity between the papers which evaluated BMAC.…”

Section: Discussionmentioning

confidence: 99%

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Intra-articular injection of orthobiologics in patients undergoing high tibial osteotomy for knee osteoarthritis is safe and effective – a systematic review

2021

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Purpose To qualitatively evaluate the current evidence reporting outcomes of intra-articular injection of orthobiologics in patients undergoing high tibial osteotomy (HTO) for osteoarthritis of the knee. Methods A systematic search methodology of the PUBMED, EMBASE, and CINAHL databases was conducted in July 2021. The search workflow was in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The following inclusion criteria were adopted: clinical trials of any level of evidence, reporting outcomes following intra-articular injection of orthobiologics during high tibial osteotomy for knee osteoarthritis, with a minimum number of 10 patients treated. Duplicate data, studies on implanted orthobiologics and articles not written in English were excluded from this review. Results Eight studies were included in this review, with a total of 585 patients. Outcomes were discussed based on the types of orthobiologics used: (i) Platelet-Rich Plasma (PRP), (ii) Bone Marrow Aspirate Concentrate (BMAC), and (iii) Injected Mesenchymal Stem Cells (MSCs). Two studies utilised PRP, 4 studies utilised BMAC and 4 studies utilised injected MSCs.. Three studies provided Level II evidence and five studies provided Level III evidence. Statistically significant improvements in outcomes were documented in multiple trials, with few patients experiencing adverse events. Conclusion Intra-articular injection of orthobiologics in patients undergoing HTO is safe and effective with good outcomes reported. Due to the lack of high-level evidence, further research is required before this can be considered standard of care. Level of evidence III

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“…Notable, the first study to compare MSCs vs. BMAC (i.e., MSCs, progenitor cells, white blood cells, etc...) on the scale of clinical and magnetic resonance imaging (MRI) outcomes in 52 patients with chondral knee defects has found no differences in retrospect between both treatments over a 2 year follow-up (336). Similarly, a recent retrospective study found no differences in postoperative radiological findings and pain/functionality outcomes in patients who underwent high tibial osteotomy with microfracture combined with either MSCs or BMAC for medial unicompartmental knee OA (337). No further studies intended to compare MSCs vs. BMAC have been made.…”

Section: Multicellular Vs Unicellular Therapiesmentioning

confidence: 99%

Cell Therapy: Types, Regulation, and Clinical Benefits

2021

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Cell therapy practices date back to the 19th century and continue to expand on investigational and investment grounds. Cell therapy includes stem cell- and non–stem cell-based, unicellular and multicellular therapies, with different immunophenotypic profiles, isolation techniques, mechanisms of action, and regulatory levels. Following the steps of their predecessor cell therapies that have become established or commercialized, investigational and premarket approval-exempt cell therapies continue to provide patients with promising therapeutic benefits in different disease areas. In this review article, we delineate the vast types of cell therapy, including stem cell-based and non–stem cell-based cell therapies, and create the first-in-literature compilation of the different “multicellular” therapies used in clinical settings. Besides providing the nuts and bolts of FDA policies regulating their use, we discuss the benefits of cell therapies reported in 3 therapeutic areas—regenerative medicine, immune diseases, and cancer. Finally, we contemplate the recent attention shift toward combined therapy approaches, highlighting the factors that render multicellular therapies a more attractive option than their unicellular counterparts.

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Allogenic Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells Are More Effective Than Bone Marrow Aspiration Concentrate for Cartilage Regeneration After High Tibial Osteotomy in Medial Unicompartmental Osteoarthritis of Knee

Cited by 38 publications

References 32 publications

Cell Sources for Cartilage Repair—Biological and Clinical Perspective

Cell Sources for Cartilage Repair—Biological and Clinical Perspective

Intra-articular injection of orthobiologics in patients undergoing high tibial osteotomy for knee osteoarthritis is safe and effective – a systematic review

Cell Therapy: Types, Regulation, and Clinical Benefits

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