Osteochondral lesions of the knee reconstructed with mesenchymal stem cells – results.

Abstract

mó rek szpi ku. Material i metody. Ma te riał kli nicz ny sta no wi ło 46 pa cjen tów z ubyt ka mi chrzęst no -kost ny mi o ró żnej etiolo gii, po twier dzo ny mi w MRI, w dwóch gru pach: 21 cho rych za opa trzo nych z uży ciem kon cen tra tu ko mó rek szpiku i 25 cho rych le czo nych za po mo cą ko mó rek me zen chy mal nych uzy ska nych z krwi ob wo do wej. Oce nę przepro wa dzo no po 6 mie sią cach, 1 ro ku i 5 lat po re kon struk cji ubyt ku na pod sta wie skal: KO OS, Ly shol ma i VAS.Wy ni ki. Au to rzy uzy ska li istot ną po pra wę we wszyst kich ska lach ocen u 40 ope ro wa nych pa cjen tów (86%). U 6 cho rych od no to wa no wy nik zły. Wy ka za no istot ną sta ty stycz nie ró żni cę w gru pach po rów ny wanych na ko rzyść cho rych le czo nych ko mór ka mi ma cie rzy sty mi po zy ska ny mi z krwi. Oce na ob ra zów MRI, u cho rych z wy ni ka mi do bry mi i bar dzo do bry mi, wy ka za ła za do wa la ją cą od bu do wę po wierzch ni chrzęst nej oraz do brą in te gra cję re ge ne ra tu. Po 5-ciu la tach od no to wa no nie wiel ki spa dek śred niej ocen kli nicz nych w obu gru pach cho rych.Wnio ski. 1. Re kon struk cja z uży ciem zmo dy fi ko wa nej tech ni ki ka nap ko wej jest sku tecz ną me to dą le czenia głę bo kich ubyt ków chrzęst no -kost nych sta wu ko la no we go. 2. Nie co gor sze wy ni ki w gru pie le czo nej koncen tra tem ko mó rek szpi ku mo że mieć swą przy czy nę w licz bie po da nych ko mó rek ma cie rzy stych.Sło wa klu czo we: cho ro by chrząst ki, mar twi ca chrzęst no -kost na, ko mór ki ma cie rzy ste, chi rur gia re kon struk cyj na SUM MA RY Background. We pre sent the re sults of the tre at ment of oste ochon dral le sions with the mo di fied san dwich tech ni que with a col la gen mem bra ne. The aim of the stu dy was to as sess and com pa re cli ni cal out co mes fol lowing the re con struc tion of oste ochon dral le sions in two gro ups of pa tients tre ated with stem cells ob ta ined from blo od and with bo ne mar row con cen tra te.Material and methods. The stu dy gro up com pri sed 46 pa tients with MRI -con fir med oste ochon dral le sions of va rio us aetio lo gy. A gro up of 21 pa tients was tre ated with bo ne mar row con cen tra te and 25 pa tients we re treated with me sen chy mal cells ob ta ined from pe ri phe ral blo od. Pa tients we re as ses sed with the use of KO OS, Lysholm and VAS sca les at 6 mon ths, and at 1 and 5 years fol lo wing the re con struc tion.Re sults. We no ted a si gni fi cant im pro ve ment across all sca les in 40 pa tients (86%). A po or out co me was no ted in 6 pa tients. The re was a sta ti sti cal ly si gni fi cant su pe rio ri ty of the gro up tre ated with stem cells ob ta ined from blo od. The ana ly sis of MRI evi den ce in pa tients with go od and excel lent re sults sho wed sa tis fac to ry recon struc tion of the car ti la gi no us sur fa ce and go od re ge ne ra te in te gra tion. At 5 years, a sli ght de cre ase in me an cli ni cal as ses sment sco res was se en in both gro ups of pa tients.Conc lu sions. 1. The mo di fied san dwich...

Bone Marrow Aspirate Concentrate Harvesting and Processing Technique

“…(BMAC, bone marrow aspirate concentrate.) [15][16][17][18] However, other studies have reported using volumes as low as 30 mL 19,20 and as high as 120 mL. 21 In the present Technical Note, 60 mL of BMAC was aspirated and later processed.…”

Avoidance of total knee arthroplasty in early osteoarthritis of the knee with intra-articular implantation of autologous activated peripheral blood stem cells versus hyaluronic acid: A randomized controlled trial with differential effects of growth factor addition

“…The ultimate autologous stem cell option is of course UC blood and tissues, due to ease of collection, storage, costs, safety, and availability, but there have as yet not been any autologous uses in OA employing that source [35]. The only clinical comparative study between stem cell types in cartilage regeneration is the study of Skowroński and Rutka [36] showing superior results for PBSC versus BM. The possibility of using autologous PBSCs obtained by leukapheresis after hG-CSF stimulation was first introduced by Saw et al [13,14,16] who treated chondral knee lesions with subchondral drilling and five postoperative IA injections of PBSCs and HA, reporting no adverse reactions and positive histological findings.…”

Quantitative Assessment of Optimal Bone Marrow Site for the Isolation of Porcine Mesenchymal Stem Cells

“…Another method to isolate MSCs is through a bedside cell concentration device that yields a bone marrow concentrate (BMC) specimen [19–26]. One advantage of such a device is the quick centrifugation step used to generate the BMC, which bypasses the time-consuming step of cell culture and expansion and enables immediate administration to the patient that may translate to clinical significance.…”