New 10 year study shows great success for stem cell treatment in knees
We are delighted to see more documented success with Mesenchymal Stem Cells (MSCs), the fascinating and powerful cells that we extract from our patients own fat for our Lipogems and AMPP procedures.
We have seen their effects first hand but in a lengthy study from the USA we are looking at a efficacy of MSCs derived from bone marrow over the course of a ten year period. This is extremely interesting because of the length of time. Currently, there are very few studies over this length of time.
MSCs are the same cells but are thought to be more powerful or concentrated when taking from the bone marrow. However, it is obviously much more intrusive to harness those cells from bone marrow, as opposed to from fat, which we can take very simply without a general anaesthetic.
The study looked at the use of bone marrow–derived mesenchymal stem cells (BMSCs) in cartilage repair procedures. The authors of this study had previously reported comparable outcomes for the 2 procedures at 2-year follow-up.
Seventy-two patients who underwent either MSC implantation—matched in terms of age and lesion site— were followed up to a median of at least 10 years. Patients were assessed with the 36-item Short Form Health Survey (SF-36), the International Knee Documentation Committee knee evaluation form, the Lysholm Knee Score, and the Tegner Activity Scale. In addition, information was obtained regarding any additional surgical procedures as well as safety data, with particular attention to infection and tumor formation.
The results show that there was an improvement in all patient-reported outcomes scores apart from the Mental Component Summary of the SF-36 after cartilage repair surgery. There was no significant difference in any of the patient-reported outcomes between cohorts at any time point. 11 patients in the group, underwent subsequent surgical procedures, including 1 total knee replacement. None of the patients in either group developed any deep infection or tumor within the follow-up period.
Bone marrow derived MSC implantation used for the treatment of chondral defects of the knee appears to result in at least equivalent clinical outcomes to first-generation ACI (autologous chondrocyte implantation) at up to 10 years.
“The ease of culture expansion as compared with chondrocytes may prove to be a decisive advantage in the older patient cohort as the age indications for these regenerative procedures continues to expand,” the authors wrote. “Moreover, [bone marrow-derived mesenchymal stem cells] BMSCs are relatively easy to isolate, with the advantage of avoiding a second surgical procedure and the associated donor site morbidity.”
The full clinical analysis is available here https://www.healio.com/orthopedics/sports-medicine/news/online/%7B7082ab6f-05eb-426f-9f8d-210e30bb2d9c%7D/bone-marrow-derived-mesenchymal-stem-cells-may-be-safe-effective-for-chondral-knee-defects
And in even greater detail here
https://journals.sagepub.com/doi/abs/10.1177/0363546519867933?journalCode=ajsb