Introduction

Clinical outcomes after the implantation of allogenic human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in osteoarthritic knees have been rarely reported. Our study aimed to investigate clinical outcomes of osteoarthritic patients who underwent hUCB-MSC implantation.

Methods

In this case series (level of evidence: 4), from January 2014 to December 2015, 128 patients with full-thickness cartilage lesions (International Cartilage Repair Society grade 4 and Kellgren–Lawrence grade ≤3) who underwent hUCB-MSC implantation were retrospectively evaluated with a minimum of 2-year follow-up. After removing the sclerotic subchondral bone with an arthroscopic burr, 4-mm-diameter holes were created at 2-mm intervals, and hyaluronic acid and hUCB-MSCs were subsequently mixed and implanted in the holes and other articular defect sites.

Clinical outcomes were evaluated preoperatively, 1 year postoperatively, and 2 years postoperatively (minimum) using visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC) scores. To assess clinical outcomes, patients were divided into two or three groups according to the lesion size, lesion location, number of lesions, body mass index, and age; statistical analyses were performed using these data.

Results

The mean (±standard deviation) VAS, WOMAC, and IKDC scores at 1 and 2 years after surgery including hUCB-MSC implantation improved significantly compared to the preoperative scores (P < 0.001). There were significant differences in the lesion location (P < 0.05). Medial femoral condyle lesions resulted in worse outcomes compared with lateral femoral condyle and trochlea lesions. No adverse reactions or postoperative complications were noted.

Conclusions

Implantation of hUCB-MSCs is effective for treating knee osteoarthritis based on a follow-up lasting a minimum of 2 years.

中文翻译：

---

移植同种异体脐带血间充质干细胞可改善膝关节骨性关节炎结果：两年随访。

介绍

在骨关节炎膝关节中植入同种异体人脐带血间充质干细胞 (hUCB-MSCs) 后的临床结果鲜有报道。我们的研究旨在调查接受 hUCB-MSC 植入的骨关节炎患者的临床结果。

方法

在本病例系列（证据级别：4）中，对 2014 年 1 月至 2015 年 12 月 128 例接受 hUCB-MSC 植入的全层软骨损伤（国际软骨修复学会 4 级和 Kellgren-Lawrence ≤3 级）的患者进行回顾性研究。至少进行 2 年的随访评估。用关节镜毛刺去除硬化的软骨下骨后，以 2 毫米间隔开出 4 毫米直径的孔，随后将透明质酸和 hUCB-MSC 混合并植入孔和其他关节缺损部位。

使用视觉模拟评分 (VAS)、西安大略大学和麦克马斯特大学骨关节炎指数 (WOMAC) 以及国际膝关节文献委员会 (IKDC) 评分在术前、术后 1 年和术后 2 年（最低）评估临床结果。为评估临床结果，根据病变大小、病变部位、病变数量、体重指数和年龄将患者分为两组或三组；使用这些数据进行统计分析。

结果

与术前评分相比，包括 hUCB-MSC 植入在内的术后 1 年和 2 年的平均（±标准差）VAS、WOMAC 和 IKDC 评分显着提高（P  < 0.001）。病变部位有显着差异（P  <0.05）。与股骨外侧髁和滑车损伤相比，股骨内侧髁损伤导致更差的结果。未发现不良反应或术后并发症。

结论

根据持续至少 2 年的随访，植入 hUCB-MSCs 可有效治疗膝骨关节炎。