Mesenchymal stem cells for Glenoid chondral lesions: An exceptional use

Abstract

Background: Damage to the articular cartilage is usually caused by accidental or athletic injuries or trauma often progressing to more severe joint diseases, such as osteoarthritis, subchondral bone necrosis, and arthritis. It is estimated that 15% of the world's adult population is affected by joint diseases. The long-term success of cartilage repair depends on the development of alternative regenerative approaches. In recent years, the use of stem cells for the treatment of degenerative diseases has been widely explored. Here we report a case of exceptional use of autologous bone marrow mesenchymal stem cells expanded in medium supplemented with autologous platelet lysate in a patient with glenoid chondral erosion.Methods: A 17-year-old patient was diagnosed as having chondral erosion of the center of the labrum in the right shoulder, with symptoms of pain and insecurity in the right upper limb. Thirty days before arthroscopy, autologous platelets and stem cells were obtaind from apheresis and BM aspiration, respectively. Arthroscopy was then performed with the patient in the lateral decubitus position with arm abducted to 45° under manual traction. Microfracture was performed in the central region defect, and MSC intra-articular injection was performe after extensive washing with sterile saline. Discussion: No adverse reactions were observed. Two years after arthroscopy, there were no sign of lesion in cartilage, rotator cuff or biceps tendon were observed in magnetic resonance imaging. Further studies are needed to validate the clinical efficacy and safety of MSC injection for glenoid chondral defect treatment. Trial registration:The procedure was approved by Hospital de Clínicas de Porto Alegre Research Ethics Committee -protocol number 14-0545.