Purpose

Knee osteoarthritis (OA) is a common, progressively debilitating joint disease, and the intra-articular injection of autologous bone marrow concentrate (BMC) may offer a minimally invasive method of harnessing the body’s own connective tissue progenitor cells to counteract accompanying degenerative effects of the disease. However, the extent to which the progenitor cell content of BMC influences treatment outcomes is unclear. We sought to determine whether patient-reported outcome measures associated with BMC treatment for knee OA are related to the concentration of progenitor cells provided.

Methods

In the present study, 65 patients (72 knees) underwent treatment for knee OA with autologous BMC and self-reported their outcomes for up to one year using follow-up questionnaires tracking function, pain, and percent improvement. A small fraction of each patient’s BMC sample was reserved for quantification with a haematological analyzer and cryopreserved for subsequent analysis of potential connective tissue progenitor cells using a colony-forming unit fibroblast (CFU-F) assay.

Results

Patients reported significant increases in function and overall percent improvement in addition to decreases in pain relative to baseline levels following treatment with autologous BMC that persisted through 12 months. Patients reporting improved outcomes (46 of 72 knees) received BMC injections having higher CFU-F concentrations than non-responding patients (21.1×10³ ± 12.4×10³ vs 14.3×10³ ± 7.0 x10³ CFU-F per mL). A progenitor cell concentration of 18×10³ CFU-F per mL of BMC was found to best differentiate responders from non-responders.

Conclusion

This study provides supportive evidence for using autologous BMC in the minimally invasive treatment of knee OA and suggests that increased progenitor cell content leads to improved treatment outcomes.

Trial registration

ClinicalTrials.gov Identifier: NCT03011398, 1/7/17

中文翻译：

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经皮自体骨髓浓缩液治疗膝骨关节炎：患者报告的结果和祖细胞含量

目的

膝骨关节炎 (OA) 是一种常见的、逐渐使人衰弱的关节疾病，关节内注射自体骨髓浓缩物 (BMC) 可能提供一种微创方法，利用人体自身的结缔组织祖细胞来抵消伴随的退行性影响疾病。然而，BMC 的祖细胞含量对治疗结果的影响程度尚不清楚。我们试图确定患者报告的与 BMC 治疗膝关节 OA 相关的结果指标是否与所提供的祖细胞浓度有关。

方法

在本研究中，65 名患者（72 个膝盖）接受了自体 BMC 治疗膝关节 OA，并使用跟踪功能、疼痛和改善百分比的随访问卷自我报告了长达一年的结果。每个患者的 BMC 样本的一小部分被保留用于用血液分析仪进行量化，并冷冻保存用于使用集落形成单位成纤维细胞 (CFU-F) 测定法对潜在的结缔组织祖细胞进行后续分析。

结果

患者报告称，在使用持续 12 个月的自体 BMC 治疗后，除了疼痛相对于基线水平有所降低外，功能和总体百分比改善也显着增加。报告改善结果的患者（72 个膝盖中的 46 个）接受的 BMC 注射具有比无反应患者更高的 CFU-F 浓度（21.1×10 3 ^± 12.4×10 ³对比 14.3×10 ³ ± 7.0 x10 ³ CFU-F/mL）。^{发现每毫升 BMC 18×10 3} CFU-F的祖细胞浓度最能区分反应者和非反应者。

结论

本研究为使用自体 BMC 微创治疗膝关节 OA 提供了支持性证据，并表明增加祖细胞含量可改善治疗效果。

试用注册

ClinicalTrials.gov 标识符：NCT03011398，1/7/17