Sholahuddin Rhatomy1,2, Jeanne Adiwinata Pawitan3,4,5, Trie Kurniawati6, Jessica Fiolin7, Ismail Hadisoebroto Dilogo4,8,9. 1. Sport and Adult Reconstruction Division, Department of Orthopaedic and Traumatology, Soeradji Tirtonegoro Hospital, Klaten, Indonesia. doktergustomrhatomy@yahoo.com. 2. Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia. doktergustomrhatomy@yahoo.com. 3. Department of Histology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. 4. Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. 5. Stem Cell and Tissue Engineering Research Cluster Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jl. Salemba Raya No. 5, Jakarta, Indonesia. 6. Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Central Hospital, Faculty of Medicine, Universitas Indonesia, Jl. Diponegoro no. 5, Jakarta, Indonesia. 7. Orthopaedic Surgeon of Jakarta Knee, Shoulder and Orthopaedic Sport Clinic, Pondok Indah General Hospital, Jl. Metro Duta Kav UE, Jakarta Selatan, 12310, Indonesia. 8. Orthopaedic and Traumatology Department, Faculty of Medicine, RS DR Cipto Mangunkusumo, Jakarta, Indonesia. 9. Stem Cell and Tissue Engineering Research Cluster Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jl. Diponegoro no 71, Jakarta, Indonesia.
Abstract
BACKGROUND: Outcomes of the current management of posterior cruciate ligament (PCL) rupture are still unsatisfactory. Recent literature demonstrated the efficacy of the paracrine action of mesenchymal stem cells (MSC) in ligament rupture healing. This study aimed to evaluate the outcome of arthroscopic administration of allogeneic umbilical cord-derived MSC (UC-MSC) conditioned medium (secretome) for the treatment of PCL rupture. PATIENTS AND METHODS: This is a prospective study including 12 individuals with PCL rupture grade 1 or 2 who were performed arthroscopy and secretome administrations. The functional and radiologic outcome of the knee was examined one year following intervention. RESULTS: Preoperatively, posterior drawer test revealed three cases of grade 2+ and nine cases of grade 1+, whereas the final follow-up revealed two cases of grade 2+ and ten cases of grade 1+ PCL rupture. At final follow-up, the mean scores for the IKDC, modified Cincinnati, and Lysholm were 90.58 ± 4.30, 90.90 ± 2.15, and 89.42 ± 3.16, respectively. The means of the serial hop tests were 90.33, 94.16, 93.66, and 95.33 for single, triple, crossover, and time hop tests, respectively. Five patients were able to resume competitive sport after an average of 25.8 weeks (25-38). The final MRI analysis revealed that six knees (50%) regained PCL continuity with low signal intensity, five knees (41.6%) returned near-normal PCL continuity, and one knee (8.3%) regained PCL continuity but with deformed outlines. CONCLUSIONS: Short-term follow-up indicated that the secretome generated from allogenic UC-MSC produces excellent functional and radiographic results in grade I-II PCL rupture.
BACKGROUND: Outcomes of the current management of posterior cruciate ligament (PCL) rupture are still unsatisfactory. Recent literature demonstrated the efficacy of the paracrine action of mesenchymal stem cells (MSC) in ligament rupture healing. This study aimed to evaluate the outcome of arthroscopic administration of allogeneic umbilical cord-derived MSC (UC-MSC) conditioned medium (secretome) for the treatment of PCL rupture. PATIENTS AND METHODS: This is a prospective study including 12 individuals with PCL rupture grade 1 or 2 who were performed arthroscopy and secretome administrations. The functional and radiologic outcome of the knee was examined one year following intervention. RESULTS: Preoperatively, posterior drawer test revealed three cases of grade 2+ and nine cases of grade 1+, whereas the final follow-up revealed two cases of grade 2+ and ten cases of grade 1+ PCL rupture. At final follow-up, the mean scores for the IKDC, modified Cincinnati, and Lysholm were 90.58 ± 4.30, 90.90 ± 2.15, and 89.42 ± 3.16, respectively. The means of the serial hop tests were 90.33, 94.16, 93.66, and 95.33 for single, triple, crossover, and time hop tests, respectively. Five patients were able to resume competitive sport after an average of 25.8 weeks (25-38). The final MRI analysis revealed that six knees (50%) regained PCL continuity with low signal intensity, five knees (41.6%) returned near-normal PCL continuity, and one knee (8.3%) regained PCL continuity but with deformed outlines. CONCLUSIONS: Short-term follow-up indicated that the secretome generated from allogenic UC-MSC produces excellent functional and radiographic results in grade I-II PCL rupture.
Authors: Michèle N J Keizer; Reinoud W Brouwer; Feike de Graaff; Roy A G Hoogeslag Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-06-23 Impact factor: 4.342