Platelet-Rich Plasma and Adipose-Derived Mesenchymal Stem Cells in Association with Arthroscopic Microfracture of Knee Articular Cartilage Defects: A Pilot Randomized Controlled Trial.


Journal

Advances in orthopedics
ISSN: 2090-3464
Titre abrégé: Adv Orthop
Pays: Egypt
ID NLM: 101565129

Informations de publication

Date de publication:
2022
Historique:
received: 01 04 2022
accepted: 16 04 2022
entrez: 9 5 2022
pubmed: 10 5 2022
medline: 10 5 2022
Statut: epublish

Résumé

This study aims to compare the effects of platelet-rich plasma (PRP) alone or in combination with adipose-derived mesenchymal stem cells (AD-MSCs) in patients affected by cartilage defects, undergoing knee arthroscopic microfracture. Thirty-eight patients diagnosed with a knee monocompartmental cartilage defect (Outerbridge grade IV) on the MRI, underwent an arthroscopic procedure. After the confirmation of the lesion, they all received the same bone marrow stimulation technique (microfracture) and were randomized into two groups: the first one had additional PRP injection (group A), while the second received PRP and AD-MSC injection (group B). Knee assessment and pain score were documented with Knee Injury Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, Short-Form (SF) 12, and Visual Analogue Scale (VAS) before the treatment and at 1, 3, 6, and 12 months of follow-up postoperatively. An additional arthroscopic procedure, performed in four patients for a subsequent meniscal lesion, let us evaluate cartilage evolution by performing a macro/microscopical assessment on cartilage biopsy specimens. At the 12-month follow-up, both groups showed a comparable functional improvement. The scores on the IKDC form, KOOS, pain VAS, and SF-12 significantly improved from baseline ( Modern regenerative medicine techniques, such as PRP and AD-MSC, associated with traditional arthroscopic bone marrow stimulating techniques, seem to enhance cartilage restoration ability. The preliminary results of this pilot study encourage the synergic use of these regenerative modulating systems to improve the quality of the regenerated cartilage.

Sections du résumé

Background UNASSIGNED
This study aims to compare the effects of platelet-rich plasma (PRP) alone or in combination with adipose-derived mesenchymal stem cells (AD-MSCs) in patients affected by cartilage defects, undergoing knee arthroscopic microfracture.
Methods UNASSIGNED
Thirty-eight patients diagnosed with a knee monocompartmental cartilage defect (Outerbridge grade IV) on the MRI, underwent an arthroscopic procedure. After the confirmation of the lesion, they all received the same bone marrow stimulation technique (microfracture) and were randomized into two groups: the first one had additional PRP injection (group A), while the second received PRP and AD-MSC injection (group B). Knee assessment and pain score were documented with Knee Injury Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, Short-Form (SF) 12, and Visual Analogue Scale (VAS) before the treatment and at 1, 3, 6, and 12 months of follow-up postoperatively. An additional arthroscopic procedure, performed in four patients for a subsequent meniscal lesion, let us evaluate cartilage evolution by performing a macro/microscopical assessment on cartilage biopsy specimens.
Results UNASSIGNED
At the 12-month follow-up, both groups showed a comparable functional improvement. The scores on the IKDC form, KOOS, pain VAS, and SF-12 significantly improved from baseline (
Conclusions UNASSIGNED
Modern regenerative medicine techniques, such as PRP and AD-MSC, associated with traditional arthroscopic bone marrow stimulating techniques, seem to enhance cartilage restoration ability. The preliminary results of this pilot study encourage the synergic use of these regenerative modulating systems to improve the quality of the regenerated cartilage.

Identifiants

pubmed: 35529427
doi: 10.1155/2022/6048477
pmc: PMC9072009
doi:

Types de publication

Journal Article

Langues

eng

Pagination

6048477

Informations de copyright

Copyright © 2022 Michele Venosa et al.

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

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Auteurs

Michele Venosa (M)

Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio Coppito 2, 67100 - L'Aquila, Italy.
RomaPro Center for Hip and Knee Arthroplasty - Polo Sanitario San Feliciano, Via Mattia Battistini, 44, 00167 - Rome, Italy.

Francesco Calafiore (F)

Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio Coppito 2, 67100 - L'Aquila, Italy.
Polo Sanitario San UOSD, Department of Mini-invasive and Computer-assisting Orthopaedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 - L'Aquila, Italy.

Manuel Mazzoleni (M)

Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio Coppito 2, 67100 - L'Aquila, Italy.
Polo Sanitario San UOSD, Department of Mini-invasive and Computer-assisting Orthopaedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 - L'Aquila, Italy.

Emilio Romanini (E)

RomaPro Center for Hip and Knee Arthroplasty - Polo Sanitario San Feliciano, Via Mattia Battistini, 44, 00167 - Rome, Italy.
GLOBE, Italian Working Group on Evidence Based Orthopaedics, Via Nicola Martelli, 3, 00197, Rome, Italy.

Simone Cerciello (S)

Orthopaedic Department, Casa di Cura Villa Betania, Via Pio IV, 42, 00165 - Rome, Italy.
Orthopaedic Department, Marrelli Hospital, Via Gioacchino da Fiore, 5, 88900 - Crotone, Italy.

Vittorio Calvisi (V)

Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio Coppito 2, 67100 - L'Aquila, Italy.
Polo Sanitario San UOSD, Department of Mini-invasive and Computer-assisting Orthopaedic Surgery, San Salvatore Hospital, Via L. Natali 1, 67100 - L'Aquila, Italy.

Classifications MeSH