Intraarticular injection of microfragmented adipose tissue plus arthroscopy in isolated primary patellofemoral osteoarthritis is clinically effective and not affected by age, BMI, or stage of osteoarthritis.
Adipose tissue
Adipose-derived stem cells
Arthroscopic debridement
Knee
Patellofemoral osteoarthritis
Journal
Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
ISSN: 1590-9999
Titre abrégé: J Orthop Traumatol
Pays: Italy
ID NLM: 101090931
Informations de publication
Date de publication:
05 Feb 2022
05 Feb 2022
Historique:
received:
19
07
2021
accepted:
25
01
2022
entrez:
5
2
2022
pubmed:
6
2
2022
medline:
9
2
2022
Statut:
epublish
Résumé
This study aimed to report the clinical and functional results of a series of patients with isolated primary patellofemoral osteoarthritis (PFOA) treated with intraarticular injection of microfragmented autologous adipose tissue plus knee arthroscopy. The results were also analyzed in relation to the age and body mas index (BMI) of patients, and to the stage of PFOA. Twenty-three patients with early-to-moderate (stage 1-3 according to the Iwano classification system) PFOA who received this treatment were retrospectively analyzed, with a mean follow-up of 22.1 ± 4.2 months. Patients were assessed using the International Knee Society (IKS) knee and function and visual analog scale (VAS) scores, and relative to their capacity for climbing stairs. Differences in improvements of IKS and VAS scores in relation to age (< 60 versus ≥ 60 years), BMI (< 30 versus ≥ 30 kg/m The mean IKS knee score significantly improved from 35.6 ± 14.9 points preoperatively to 61.9 ± 17.8 points at the latest follow-up, while the mean IKS function score significantly improved from 52.0 ± 14.7 points preoperatively to 82.3 ± 19.1 points at the latest follow-up. The mean VAS score significantly decreased from 8.7 ± 2.2 preoperatively to 5.2 ± 2.5 at the latest follow-up. A significant improvement in the capacity to climb stairs was found. No significant differences in improvements of IKS knee and function and VAS scores were found in relation to age, BMI, or stage of PFOA. Intraarticular injection of microfragmented autologous adipose tissue following arthroscopic debridement significantly improved overall clinical and functional scores in patients with early or moderate isolated primary PFOA at a mean follow-up of almost 2 years. Improvements were not significantly affected by age, BMI, or stage of PFOA. Level IV, retrospective case series.
Identifiants
pubmed: 35122541
doi: 10.1186/s10195-022-00628-9
pii: 10.1186/s10195-022-00628-9
pmc: PMC8818068
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7Informations de copyright
© 2022. The Author(s).
Références
Adriani E, Moio M, Di Paola B, Salustri W, Alfieri A, Parisi P, Ruggiero M, Borab Z, Carlesimo B (2017) Percutaneous fat transfer to treat knee osteoarthritis symptoms: preliminary results. Joints 5:89–92
doi: 10.1055/s-0037-1603672
Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M, Seil R (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 25:335–346
doi: 10.1007/s00167-016-4407-4
Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C (2013) A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 22:2063–2077
doi: 10.3727/096368912X657855
Caplan AI (2015) Adult mesenchymal stem cells: when, where, and how. Stem Cells Int 2015:628767. https://doi.org/10.1155/2015/628767
doi: 10.1155/2015/628767
pubmed: 26273305
pmcid: 4529977
Coughlin RP, Oldweiler A, Mickelson DT, Moorman CT (2017) Adipose-derived stem cell transplant technique for degenerative joint disease. Arthrosc Tech 6:e1761–e1766
doi: 10.1016/j.eats.2017.06.048
Cui GH, Wang YY, Li CJ, Shi CH, Wang WS (2016) Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: a meta-analysis. Exp Ther Med 12:3390–3400
doi: 10.3892/etm.2016.3791
Damia E, Chicharro D, Lopez S, Cuervo B, Rubio M, Sopena JJ, Vilar JM, Carrillo JM (2018) Adipose-derived mesenchymal stem cells: are they a good therapeutic strategy for osteoarthritis? Int J Mol Sci 19(7):1926
doi: 10.3390/ijms19071926
De Deugd CM, Pareek A, Krych AJ, Cummings NM, Dahm DL (2017) Outcomes of patellofemoral arthroplasty based on radiographic severity. J Arthroplasty 32(4):1137–1142
doi: 10.1016/j.arth.2016.11.006
Dejour D, Saffarini M, Malemo Y, Pungitore M, Valluy J, Nover L, Demey G (2019) Early outcomes of an anatomic trochlear-cutting patellofemoral arthroplasty: patient selection is key. Knee Surg Sports Traumatol Arthrosc 27(7):2297–2302
doi: 10.1007/s00167-019-05368-8
Delanois RE, McGrath MS, Ulrich SD, Marker DR, Seyler TM, Bonutti PM, Mont MA (2008) Results of total knee replacement for isolated patellofemoral arthritis: when not to perform a patellofemoral arthroplasty. Orthop Clin North Am 39(3):381–388
doi: 10.1016/j.ocl.2008.03.003
Freitag J, Bates D, Wickham J, Shah K, Huguenin L, Tenen A, Paterson K, Boyd R (2019) Adipose-derived mesenchymal stem cell therapy in the treatment of knee osteoarthritis: a randomized controlled trial. Regen Med 14:213–230
doi: 10.2217/rme-2018-0161
Garza JR, Campbell RE, Tjoumakaris FP, Freedman KB, Miller LS, Santa Maria D, Tucker BS (2020) Clinical efficacy of intra-articular mesenchymal stromal cells for the treatment of the knee osteoarthritis. a double-blinded prospective randomized controlled clinical trial. Am J Sport Med 48(3):588–598
doi: 10.1177/0363546519899923
Grieshober JA, Stanton M, Gambardella R (2016) Debridement of articular cartilage: the natural course. Sports Med Arthrosc Rev 24:56–62
doi: 10.1097/JSA.0000000000000108
Guimãres MV, da Graça Morais Rios PA, Ruiz MA, Noronha CP, Terra DL, Lana JFSD (2018) Patellofemoral osteoarthritis: treatment with autologous bone marrow mononuclear cells and arthroscopic surgery, a prospective study. Stem Cell Regener Med 2:2–7
Hong Z, Chen J, Zhang S, Zhao C, Bi M, Chen X, Bi Q (2019) Intra-articular injection of autologous adipose-derived stromal vascular fractions for knee osteoarthritis: a double-blind randomized self-controlled trial. Int Orthop 43:1123–1134
doi: 10.1007/s00264-018-4099-0
Hudetz D, Borić I, Rod E, Jeleč Ž, Radić A, Vrdoljak T, Skelin A, Lauc G, Trbojević-Akmačić I, Plečko M, Polašek O, Primorac D (2017) The effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis. Genes 8(10):270
doi: 10.3390/genes8100270
Hurley ET, Yasui Y, Gianakos AL, Seow D, Shimozono Y, Kerkhoffs GMMJ, Kennedy JG (2018) Limited evidence for adipose-derived stem cell therapy on the treatment of osteoarthritis. Knee Surg Sports Traumatol Arthrosc 26:3499–3507
doi: 10.1007/s00167-018-4955-x
Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14
doi: 10.1097/00003086-198911000-00004
Iwano T, Kurosawa H, Tokuyama H, Hoshikawa Y (1990) Roentgenographic and clinical findings of patellofemoral osteoarthrosis. With special reference to its relationship to femorotibial osteoarthrosis and etiologic factors. Clin Orthop Relat Res 252:190–197
doi: 10.1097/00003086-199003000-00028
Jin YZ, Lee JH (2018) Mesenchymal stem cell therapy for bone regeneration. Clin Orthop Surg 10:271–278
doi: 10.4055/cios.2018.10.3.271
Jo CH, Chai JW, Jeong EC, Oh S, Shin JS, Shim H, Yoon KS (2017) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a 2-year follow-up study. Am J Sports Med 45:2774–2783
doi: 10.1177/0363546517716641
Jo CH, Lee YG, Shin WH (2014) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof of concept clinical trial. Stem Cells 32:1254–1266
doi: 10.1002/stem.1634
Katz JN, Brownlee SA, Jones MH (2014) The role of arthroscopy in the management of knee osteoarthritis. Best Pract Res Clin Rheumatol 28:143–156
doi: 10.1016/j.berh.2014.01.008
Kobayashi S, Pappas E, Fransen M, Refshauge K, Simic M (2016) The prevalence of patellofemoral osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartil 24(10):1697–1707
doi: 10.1016/j.joca.2016.05.011
Lankhorst NE, Damen J, Oei EH, Verhaar JAN, Kloppenburg M, Bierma-Zeinstra SMA, van Middelkoop M (2017) Incidence, prevalence, natural course and prognosis of patellofemoral osteoarthritis: the Cohort Hip and Cohort Knee study. Osteoarthr Cartil 25(5):647–653
doi: 10.1016/j.joca.2016.12.006
Lee WS, Kim HJ, Kim KI, Kim GB, Jin W (2019) Intra-articular injection of autologous adipose tissue-derived mesenchymal stem cells for the treatment of knee osteoarthritis: a phase IIb, randomized, placebo-controlled clinical trial. Stem Cells Transl Med 8(6):504–511
doi: 10.1002/sctm.18-0122
Lu L, Dai C, Zhang Z, Du H, Li S, Ye P, Fu Q, Zhang L, Wu X, Dong Y, Song Y, Zhao D, Pang Y, Bao C (2019) Treatment of knee osteoarthritis with intra-articular injection of autologous adipose-derived mesenchymal progenitor cells: a prospective, randomized, double-blind, active-controlled, phase IIb clinical trial. Stem Cell Res Ther 10(1):143
doi: 10.1186/s13287-019-1248-3
Ma W, Liu C, Wang S, Xu H, Sun H, Fan X (2019) Efficacy and safety of intra-articular injection of mesenchymal stem cells in the treatment of knee osteoarthritis. A systematic review and meta-analysis. Medicine 99(49):e23343
doi: 10.1097/MD.0000000000023343
Merceron C, Portron S, Masson M, Fellah BH, Gauthier O, Lesoeur J, Chèrel Y, Weiss P, Guicheux J, Vinatier C (2010) Cartilage tissue engineering: from hydrogel to mesenchymal stem cells. Biomed Mater Eng 20:159–166
pubmed: 20930323
Misso ML, Pitt VJ, Jones KM, Barnes HN, Piterman L, Green SE (2008) Quality and consistency of clinical practice guidelines for diagnosis and management of osteoarthritis of the hip and knee: a descriptive overview of published guidelines. Med J Aust 189:394–399
doi: 10.5694/j.1326-5377.2008.tb02086.x
Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, Sensebe L, Casteilla L, Fleury S, Bourin P, Noël D, Canovas F, Cyteval C, Lisignoli G, Schrauth J, Haddad D, Domergue S, Noeth U, Jorgensen C, ADIPOA Consortium (2016) Adipose mesenchymal stromal cell-based therapy for severe osteoarthritis of the knee: a phase I dose-escalation trial. Stem Cells Transl Med 5:847–856
doi: 10.5966/sctm.2015-0245
Pintat J, Silvestre A, Magalon G, Gadeau AP, Pesquer L, Perozziello A, Peuchant A, Mounayer C, Dallaudière B (2017) Intra-articular injection of mesenchymal stem cells and platelet-rich plasma to treat patellofemoral osteoarthritis: preliminary results of a long-term pilot study. J Vasc Inter Radiol 28(12):1708–1713
doi: 10.1016/j.jvir.2017.08.004
Rodriguez-Merchan EC (2020) The present situation of patellofemoral arthroplasty in the management of solitary patellofemoral osteoarthritis. Arch Bone Jt Surg 8(3):325–331
pubmed: 32766389
pmcid: 7358247
Schiavone Panni A, Del Regno C, Mazzitelli G, D’Apolito R, Corona K, Vasso M (2017) Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc 26(4):1130–1136
pubmed: 28324152
Schiavone Panni A, Vasso M, Braile A, Toro G, De Cicco A, Viggiano D, Lepore F (2019) Preliminary results of autologous adipose-derived stem cells in early knee osteoarthritis: identification of a subpopulation with greater response. Int Orthop 43:7–13
doi: 10.1007/s00264-018-4182-6
Van Genechten W, Vuylsteke K, Swinnen L, Martinez PR, Verdonk P (2020) Autologous protein solution as selective treatment for advanced patellofemoral osteoarthritis in the middle-aged female patients: 54% response rate at 1year follow-up. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-06064-8
doi: 10.1007/s00167-020-06064-8
pubmed: 32451622
van Jonbergen HP, Werkman DM, Barnaart LF, van Kampen A (2010) Long-term outcomes of patellofemoral arthroplasty. J Arthroplasty 25:1066–1071
doi: 10.1016/j.arth.2009.08.023