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Mesenchymal Stem Cell Implantation in Osteoarthritic Knees: Is Fibrin Glue Effective as a Scaffold?
Background: The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat pati...
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| Published in: | The American journal of sports medicine 2015-01, Vol.43 (1), p.176-185 |
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| container_title | The American journal of sports medicine |
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| creator | Kim, Yong Sang Choi, Yun Jin Suh, Dong Suk Heo, Dong Beom Kim, Yong Il Ryu, Jae-Sung Koh, Yong Gon |
| description | Background:
The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions.
Purpose:
To investigate the clinical and second-look arthroscopic outcomes of the implantation of MSCs loaded in fibrin glue as a scaffold in patients with OA knees and to compare these outcomes with those of MSC implantation without a scaffold.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
This study retrospectively evaluated 54 patients (56 knees) who were examined with second-look arthroscopy after MSC implantation for cartilage lesions in their OA knees. Patients were divided into 2 groups: 37 patients (39 knees) were treated with MSC implantation without a scaffold (group 1), and 17 patients (17 knees) underwent implantation of MSCs loaded in fibrin glue as a scaffold (group 2). Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed with the International Cartilage Repair Society (ICRS) grade. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes.
Results:
At final follow-up (mean, 28.6 months; range, 24-34 months), the mean IKDC score and Tegner activity scale in each group significantly improved: group 1, from 38.1 ± 7.7 to 62.0 ± 11.7 (IKDC) and from 2.5 ± 0.9 to 3.5 ± 0.8 (Tegner); group 2, from 36.1 ± 6.2 to 64.4 ± 11.5 (IKDC) and from 2.2 ± 0.8 to 3.8 ± 0.8 (Tegner) (P < .001 for all). According to the overall ICRS cartilage repair grades, 9 of the 39 lesions (23%) in group 1 and 12 of the 17 lesions (58%) in group 2 achieved a grade of I or II. There was a significant difference in ICRS grades between the groups (P = .028). Overweight (body mass index ≥ 27.5 kg/m2) and large lesion size (≥5.7 cm2) were significant predictors of poor clinical and arthroscopic outcomes in group 1 (P < .05 for both). There was a similar trend in group 2, but the differences were not significant, possibly owing to the smaller sample size.
Conclusion:
Clinical and arthroscopic outcomes of MSC implantation were encouraging for OA knees in both groups, although there were no significant differences in outcome scores between gr |
| doi_str_mv | 10.1177/0363546514554190 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1701495613</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546514554190</sage_id><sourcerecordid>1641857086</sourcerecordid><originalsourceid>FETCH-LOGICAL-c351t-3de84d4f1ee34cdb2bff6196dea42cede9acedeb0c1c5b443da7c23956135de93</originalsourceid><addsrcrecordid>eNqFkTlPw0AQhVcIREKgp0KWaGgMO3vZpkMRRwQoBVBb6_WYOPIRvOsi_541CQhFQjQzxfvmzUXIKdBLgCi6olxxKZQEIaWAhO6RMUjJQs6V3CfjQQ4HfUSOrF1SSiFS8SEZMclFwhQfk-tntNiYxbrWVfDisA6mWFXBrF5VunHalW0TlE0wtw5b3blFV7rSBI8Noj0mB4WuLJ5s84S83d2-Th_Cp_n9bHrzFBouwYU8x1jkogBELkyesawoFCQqRy2YwRwTPcSMGjAyE4LnOjKMJ1IBl17lE3Kx8V117UeP1qV1aY2fUjfY9jaFiIL4wv9HlYBYRjRWHj3fQZdt3zV-EU9JBnEClHmKbijTtdZ2WKSrrqx1t06BpsML0t0X-JKzrXGf1Zj_FHzf3APhBrD6HX91_cvwEwcxjNI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1652189102</pqid></control><display><type>article</type><title>Mesenchymal Stem Cell Implantation in Osteoarthritic Knees: Is Fibrin Glue Effective as a Scaffold?</title><source>Sage Journals Online</source><source>EBSCOhost SPORTDiscus - Ebooks</source><creator>Kim, Yong Sang ; Choi, Yun Jin ; Suh, Dong Suk ; Heo, Dong Beom ; Kim, Yong Il ; Ryu, Jae-Sung ; Koh, Yong Gon</creator><creatorcontrib>Kim, Yong Sang ; Choi, Yun Jin ; Suh, Dong Suk ; Heo, Dong Beom ; Kim, Yong Il ; Ryu, Jae-Sung ; Koh, Yong Gon</creatorcontrib><description>Background:
The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions.
Purpose:
To investigate the clinical and second-look arthroscopic outcomes of the implantation of MSCs loaded in fibrin glue as a scaffold in patients with OA knees and to compare these outcomes with those of MSC implantation without a scaffold.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
This study retrospectively evaluated 54 patients (56 knees) who were examined with second-look arthroscopy after MSC implantation for cartilage lesions in their OA knees. Patients were divided into 2 groups: 37 patients (39 knees) were treated with MSC implantation without a scaffold (group 1), and 17 patients (17 knees) underwent implantation of MSCs loaded in fibrin glue as a scaffold (group 2). Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed with the International Cartilage Repair Society (ICRS) grade. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes.
Results:
At final follow-up (mean, 28.6 months; range, 24-34 months), the mean IKDC score and Tegner activity scale in each group significantly improved: group 1, from 38.1 ± 7.7 to 62.0 ± 11.7 (IKDC) and from 2.5 ± 0.9 to 3.5 ± 0.8 (Tegner); group 2, from 36.1 ± 6.2 to 64.4 ± 11.5 (IKDC) and from 2.2 ± 0.8 to 3.8 ± 0.8 (Tegner) (P < .001 for all). According to the overall ICRS cartilage repair grades, 9 of the 39 lesions (23%) in group 1 and 12 of the 17 lesions (58%) in group 2 achieved a grade of I or II. There was a significant difference in ICRS grades between the groups (P = .028). Overweight (body mass index ≥ 27.5 kg/m2) and large lesion size (≥5.7 cm2) were significant predictors of poor clinical and arthroscopic outcomes in group 1 (P < .05 for both). There was a similar trend in group 2, but the differences were not significant, possibly owing to the smaller sample size.
Conclusion:
Clinical and arthroscopic outcomes of MSC implantation were encouraging for OA knees in both groups, although there were no significant differences in outcome scores between groups. However, at second-look arthroscopy, there were better ICRS grades in group 2.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546514554190</identifier><identifier>PMID: 25349263</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Arthritis ; Arthroscopy ; Cartilage ; Cartilage, Articular - pathology ; Cartilage, Articular - surgery ; Female ; Fibrin Tissue Adhesive - therapeutic use ; Follow-Up Studies ; Humans ; Knee ; Knee Joint - surgery ; Lysholm Knee Score ; Male ; Mesenchymal Stem Cell Transplantation - methods ; Middle Aged ; Osteoarthritis, Knee - surgery ; Overweight - complications ; Retrospective Studies ; Second-Look Surgery ; Sports medicine ; Stem cells ; Tissue Adhesives - therapeutic use ; Tissue Engineering ; Tissue Scaffolds ; Transplants & implants ; Treatment Outcome</subject><ispartof>The American journal of sports medicine, 2015-01, Vol.43 (1), p.176-185</ispartof><rights>2014 The Author(s)</rights><rights>2014 The Author(s).</rights><rights>Copyright Sage Publications Ltd. Jan 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-3de84d4f1ee34cdb2bff6196dea42cede9acedeb0c1c5b443da7c23956135de93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25349263$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Yong Sang</creatorcontrib><creatorcontrib>Choi, Yun Jin</creatorcontrib><creatorcontrib>Suh, Dong Suk</creatorcontrib><creatorcontrib>Heo, Dong Beom</creatorcontrib><creatorcontrib>Kim, Yong Il</creatorcontrib><creatorcontrib>Ryu, Jae-Sung</creatorcontrib><creatorcontrib>Koh, Yong Gon</creatorcontrib><title>Mesenchymal Stem Cell Implantation in Osteoarthritic Knees: Is Fibrin Glue Effective as a Scaffold?</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions.
Purpose:
To investigate the clinical and second-look arthroscopic outcomes of the implantation of MSCs loaded in fibrin glue as a scaffold in patients with OA knees and to compare these outcomes with those of MSC implantation without a scaffold.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
This study retrospectively evaluated 54 patients (56 knees) who were examined with second-look arthroscopy after MSC implantation for cartilage lesions in their OA knees. Patients were divided into 2 groups: 37 patients (39 knees) were treated with MSC implantation without a scaffold (group 1), and 17 patients (17 knees) underwent implantation of MSCs loaded in fibrin glue as a scaffold (group 2). Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed with the International Cartilage Repair Society (ICRS) grade. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes.
Results:
At final follow-up (mean, 28.6 months; range, 24-34 months), the mean IKDC score and Tegner activity scale in each group significantly improved: group 1, from 38.1 ± 7.7 to 62.0 ± 11.7 (IKDC) and from 2.5 ± 0.9 to 3.5 ± 0.8 (Tegner); group 2, from 36.1 ± 6.2 to 64.4 ± 11.5 (IKDC) and from 2.2 ± 0.8 to 3.8 ± 0.8 (Tegner) (P < .001 for all). According to the overall ICRS cartilage repair grades, 9 of the 39 lesions (23%) in group 1 and 12 of the 17 lesions (58%) in group 2 achieved a grade of I or II. There was a significant difference in ICRS grades between the groups (P = .028). Overweight (body mass index ≥ 27.5 kg/m2) and large lesion size (≥5.7 cm2) were significant predictors of poor clinical and arthroscopic outcomes in group 1 (P < .05 for both). There was a similar trend in group 2, but the differences were not significant, possibly owing to the smaller sample size.
Conclusion:
Clinical and arthroscopic outcomes of MSC implantation were encouraging for OA knees in both groups, although there were no significant differences in outcome scores between groups. However, at second-look arthroscopy, there were better ICRS grades in group 2.</description><subject>Arthritis</subject><subject>Arthroscopy</subject><subject>Cartilage</subject><subject>Cartilage, Articular - pathology</subject><subject>Cartilage, Articular - surgery</subject><subject>Female</subject><subject>Fibrin Tissue Adhesive - therapeutic use</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Joint - surgery</subject><subject>Lysholm Knee Score</subject><subject>Male</subject><subject>Mesenchymal Stem Cell Transplantation - methods</subject><subject>Middle Aged</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Overweight - complications</subject><subject>Retrospective Studies</subject><subject>Second-Look Surgery</subject><subject>Sports medicine</subject><subject>Stem cells</subject><subject>Tissue Adhesives - therapeutic use</subject><subject>Tissue Engineering</subject><subject>Tissue Scaffolds</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqFkTlPw0AQhVcIREKgp0KWaGgMO3vZpkMRRwQoBVBb6_WYOPIRvOsi_541CQhFQjQzxfvmzUXIKdBLgCi6olxxKZQEIaWAhO6RMUjJQs6V3CfjQQ4HfUSOrF1SSiFS8SEZMclFwhQfk-tntNiYxbrWVfDisA6mWFXBrF5VunHalW0TlE0wtw5b3blFV7rSBI8Noj0mB4WuLJ5s84S83d2-Th_Cp_n9bHrzFBouwYU8x1jkogBELkyesawoFCQqRy2YwRwTPcSMGjAyE4LnOjKMJ1IBl17lE3Kx8V117UeP1qV1aY2fUjfY9jaFiIL4wv9HlYBYRjRWHj3fQZdt3zV-EU9JBnEClHmKbijTtdZ2WKSrrqx1t06BpsML0t0X-JKzrXGf1Zj_FHzf3APhBrD6HX91_cvwEwcxjNI</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Kim, Yong Sang</creator><creator>Choi, Yun Jin</creator><creator>Suh, Dong Suk</creator><creator>Heo, Dong Beom</creator><creator>Kim, Yong Il</creator><creator>Ryu, Jae-Sung</creator><creator>Koh, Yong Gon</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20150101</creationdate><title>Mesenchymal Stem Cell Implantation in Osteoarthritic Knees</title><author>Kim, Yong Sang ; Choi, Yun Jin ; Suh, Dong Suk ; Heo, Dong Beom ; Kim, Yong Il ; Ryu, Jae-Sung ; Koh, Yong Gon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-3de84d4f1ee34cdb2bff6196dea42cede9acedeb0c1c5b443da7c23956135de93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Arthritis</topic><topic>Arthroscopy</topic><topic>Cartilage</topic><topic>Cartilage, Articular - pathology</topic><topic>Cartilage, Articular - surgery</topic><topic>Female</topic><topic>Fibrin Tissue Adhesive - therapeutic use</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Joint - surgery</topic><topic>Lysholm Knee Score</topic><topic>Male</topic><topic>Mesenchymal Stem Cell Transplantation - methods</topic><topic>Middle Aged</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Overweight - complications</topic><topic>Retrospective Studies</topic><topic>Second-Look Surgery</topic><topic>Sports medicine</topic><topic>Stem cells</topic><topic>Tissue Adhesives - therapeutic use</topic><topic>Tissue Engineering</topic><topic>Tissue Scaffolds</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Yong Sang</creatorcontrib><creatorcontrib>Choi, Yun Jin</creatorcontrib><creatorcontrib>Suh, Dong Suk</creatorcontrib><creatorcontrib>Heo, Dong Beom</creatorcontrib><creatorcontrib>Kim, Yong Il</creatorcontrib><creatorcontrib>Ryu, Jae-Sung</creatorcontrib><creatorcontrib>Koh, Yong Gon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Yong Sang</au><au>Choi, Yun Jin</au><au>Suh, Dong Suk</au><au>Heo, Dong Beom</au><au>Kim, Yong Il</au><au>Ryu, Jae-Sung</au><au>Koh, Yong Gon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mesenchymal Stem Cell Implantation in Osteoarthritic Knees: Is Fibrin Glue Effective as a Scaffold?</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>43</volume><issue>1</issue><spage>176</spage><epage>185</epage><pages>176-185</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Background:
The cell-based tissue engineering approach that uses mesenchymal stem cells (MSCs) has addressed the issue of articular cartilage repair in osteoarthritic (OA) knees. However, to improve outcomes, an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions.
Purpose:
To investigate the clinical and second-look arthroscopic outcomes of the implantation of MSCs loaded in fibrin glue as a scaffold in patients with OA knees and to compare these outcomes with those of MSC implantation without a scaffold.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
This study retrospectively evaluated 54 patients (56 knees) who were examined with second-look arthroscopy after MSC implantation for cartilage lesions in their OA knees. Patients were divided into 2 groups: 37 patients (39 knees) were treated with MSC implantation without a scaffold (group 1), and 17 patients (17 knees) underwent implantation of MSCs loaded in fibrin glue as a scaffold (group 2). Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed with the International Cartilage Repair Society (ICRS) grade. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes.
Results:
At final follow-up (mean, 28.6 months; range, 24-34 months), the mean IKDC score and Tegner activity scale in each group significantly improved: group 1, from 38.1 ± 7.7 to 62.0 ± 11.7 (IKDC) and from 2.5 ± 0.9 to 3.5 ± 0.8 (Tegner); group 2, from 36.1 ± 6.2 to 64.4 ± 11.5 (IKDC) and from 2.2 ± 0.8 to 3.8 ± 0.8 (Tegner) (P < .001 for all). According to the overall ICRS cartilage repair grades, 9 of the 39 lesions (23%) in group 1 and 12 of the 17 lesions (58%) in group 2 achieved a grade of I or II. There was a significant difference in ICRS grades between the groups (P = .028). Overweight (body mass index ≥ 27.5 kg/m2) and large lesion size (≥5.7 cm2) were significant predictors of poor clinical and arthroscopic outcomes in group 1 (P < .05 for both). There was a similar trend in group 2, but the differences were not significant, possibly owing to the smaller sample size.
Conclusion:
Clinical and arthroscopic outcomes of MSC implantation were encouraging for OA knees in both groups, although there were no significant differences in outcome scores between groups. However, at second-look arthroscopy, there were better ICRS grades in group 2.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25349263</pmid><doi>10.1177/0363546514554190</doi><tpages>10</tpages></addata></record> |
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| source | Sage Journals Online; EBSCOhost SPORTDiscus - Ebooks |
| subjects | Arthritis Arthroscopy Cartilage Cartilage, Articular - pathology Cartilage, Articular - surgery Female Fibrin Tissue Adhesive - therapeutic use Follow-Up Studies Humans Knee Knee Joint - surgery Lysholm Knee Score Male Mesenchymal Stem Cell Transplantation - methods Middle Aged Osteoarthritis, Knee - surgery Overweight - complications Retrospective Studies Second-Look Surgery Sports medicine Stem cells Tissue Adhesives - therapeutic use Tissue Engineering Tissue Scaffolds Transplants & implants Treatment Outcome |
| title | Mesenchymal Stem Cell Implantation in Osteoarthritic Knees: Is Fibrin Glue Effective as a Scaffold? |
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