Ricardo Bastos1,2,3,4,5,6, Marcelo Mathias2, Renato Andrade1,3,7, Ronaldo J F C Amaral8,9,10, Vinicius Schott2, Alex Balduino11, Raquel Bastos12, J Miguel Oliveira4,5,13, Rui L Reis4,5,13, Scott Rodeo14, João Espregueira-Mendes15,16,17,18. 1. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. 2. Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil. 3. Dom Henrique Research Centre, Porto, Portugal. 4. 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017, Guimarães, Portugal. 5. ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal. 6. The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, England. 7. Faculty of Sports, University of Porto, Porto, Portugal. 8. Kearney Lab, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland. 9. Tissue Engineering Research Group, Department of Anatomy, RCSI, Dublin 2, Ireland. 10. Centre for Research in Medical Devices (CURAM), National University of Ireland Galway, Galway, Ireland. 11. Excellion, Nireói, Rio de Janeiro, Brazil. 12. Hospital Lusíadas, Porto, Portugal. 13. The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, Barco, 4805-017, Guimarães, Portugal. 14. Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York, NY, USA. 15. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. espregueira@dhresearchcentre.com. 16. Dom Henrique Research Centre, Porto, Portugal. espregueira@dhresearchcentre.com. 17. ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal. espregueira@dhresearchcentre.com. 18. Orthopaedics Department of Minho University, Braga, Portugal. espregueira@dhresearchcentre.com.
Abstract
PURPOSE: To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA). METHODS:Forty-seven patients with radiographic and symptomatic knee OA were randomized into three groups for intra-articular injections: autologous bone marrow-derived culture-expanded MSCs (n = 16); autologous bone marrow-derived culture-expanded MSCs + PRP (n = 14); and corticosteroid (n = 17). The outcomes were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and range of motion (ROM) at baseline, 1, 2, 3, 6, 9 and 12 months and intra-articular cytokines analysis at baseline, 6 and 12 months postoperatively. RESULTS: The three groups showed significant improvement in most KOOS domains and global score at 1st month and all domains and global score at 12-month follow-up (p < 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (p = 0.003). The MSCs and MSCs + PRP groups showed the highest percentage of improvement in most KOOS domains and global score compared to the corticosteroid group. All three groups showed a significant reduction in intra-articular levels of human interleukin-10 cytokine, from baseline to 12 months (p < 0.05). CONCLUSION: An intra-articular injection of bone marrow-derived culture-expanded MSCs with or without the addiction of PRP is effective in improving the function and decreasing symptoms caused by knee OA at 12-month follow-up. LEVEL OF EVIDENCE: II.
RCT Entities:
PURPOSE: To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA). METHODS: Forty-seven patients with radiographic and symptomatic knee OA were randomized into three groups for intra-articular injections: autologous bone marrow-derived culture-expanded MSCs (n = 16); autologous bone marrow-derived culture-expanded MSCs + PRP (n = 14); and corticosteroid (n = 17). The outcomes were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and range of motion (ROM) at baseline, 1, 2, 3, 6, 9 and 12 months and intra-articular cytokines analysis at baseline, 6 and 12 months postoperatively. RESULTS: The three groups showed significant improvement in most KOOS domains and global score at 1st month and all domains and global score at 12-month follow-up (p < 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (p = 0.003). The MSCs and MSCs + PRP groups showed the highest percentage of improvement in most KOOS domains and global score compared to the corticosteroid group. All three groups showed a significant reduction in intra-articular levels of humaninterleukin-10 cytokine, from baseline to 12 months (p < 0.05). CONCLUSION: An intra-articular injection of bone marrow-derived culture-expanded MSCs with or without the addiction of PRP is effective in improving the function and decreasing symptoms caused by knee OA at 12-month follow-up. LEVEL OF EVIDENCE: II.
Authors: R Ferracini; M Alessio-Mazzola; B Sonzogni; C Stambazzi; C Ursino; I Roato; F Mussano; A Bistolfi; S Furlan; L Godio; D Alotto; M Formica Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-09-10 Impact factor: 4.114
Authors: José María Lamo-Espinosa; Juan F Blanco; Mikel Sánchez; Victoria Moreno; Froilán Granero-Moltó; Fermín Sánchez-Guijo; Íñigo Crespo-Cullel; Gonzalo Mora; Diego Delgado San Vicente; Orlando Pompei-Fernández; Jesús Dámaso Aquerreta; Jorge María Núñez-Córdoba; María Vitoria Sola; Andrés Valentí-Azcárate; Enrique J Andreu; María Del Consuelo Del Cañizo; Juan Ramón Valentí-Nin; Felipe Prósper Journal: J Transl Med Date: 2020-09-18 Impact factor: 5.531