Impact on the quality of life of patients suffering from osteoarthritis of the knee after intra-articular administration of bone marrow mononuclear cells

Abstract

Objective: The aim of this study was to evaluate the combined treatment of BMMCs alone or in combination of arthroscopic debridement and lavage in treatment of knee OA through resonance image and quality of life questionnaire. In comparison to the mesenchymal stem cells (MSC), the effectiveness is lower, however the costs for manipulation and laboratory handling make it difficult to use in clinical practice.Design: This was a pilot, longitudinal and prospective trial with two years of follow-up. Twenty-one patients with patellofemoral osteoarthritis who met the study criteria were included. The patients were divided into three groups: BMMCs+Arthroscopy; BMMCs+lavage; BMMC. Clinical outcomes were evaluated using SF-36 questionnaire at baseline and two years after the procedure. Results:In this study, it was verified a high recovery of BMMCs and platelets, especially with manual separation. It was not observed differences in SF-36 when comparing the three groups, however the evaluation of SF-36 baseline and two years of follow-up in each one of the three groups, it was showed an improvement in 3-4 parameters. The MRI showed an improvement in the stroke, subchondral bone and cartilage size in the patella and femur. Conclusion:This study demonstrated that OA showed a significant improvement, measured by quality life questionnaire, only with the use of BMMCs, showing no improvement with the combination of arthroscopy or joint lavage. In this way, the use of BMMC´s is well accepted, a presented impact on parameters of SF-36. None of the patients underwent total knee arthroplasty. A study with a higher number of patients is of great value to assess the safety and efficacy of BMMC´s application.