Implantation of hUCB‐MSCs generates greater hyaline‐type cartilage than microdrilling combined with high tibial osteotomy
Purpose To compare the outcomes of treating large cartilage defects in knee osteoarthritis using human allogeneic umbilical cord blood‐derived mesenchymal stem cell (hUCB‐MSC) implantation or arthroscopic microdrilling as a supplementary cartilage regenerative procedure combined with high tibial ost...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2024-04, Vol.32 (4), p.829-842 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Jung, Se‐Han Park, Hyunjin Jung, Min Chung, Kwangho Kim, Sungjun Moon, Hyun‐Soo Park, Jisoo Lee, Ju‐Hyung Choi, Chong‐Hyuk Kim, Sung‐Hwan |
| description | Purpose
To compare the outcomes of treating large cartilage defects in knee osteoarthritis using human allogeneic umbilical cord blood‐derived mesenchymal stem cell (hUCB‐MSC) implantation or arthroscopic microdrilling as a supplementary cartilage regenerative procedure combined with high tibial osteotomy (HTO).
Methods
This 1‐year prospective comparative study included 25 patients with large, near full‐thickness cartilage defects (International Cartilage Repair Society grade ≥ IIIB) in the medial femoral condyles and varus malalignment. Defects were treated with hUCB‐MSC implantation or arthroscopic microdrilling combined with HTO. The primary outcomes were pain visual analogue scale and International Knee Documentation Committee subjective scores at 12, 24 and 48 weeks. Secondary outcomes included arthroscopic, histological and magnetic resonance imaging assessments at 1 year.
Results
Fifteen and 10 patients were treated via hUCB‐MSC implantation and microdrilling, respectively. Baseline demographics, limb alignment and clinical outcomes did not significantly differ between the groups. Cartilage defects and total restored areas were significantly larger in the hUCB‐MSC group (7.2 ± 1.9 vs. 5.2 ± 2.1 cm2, p = 0.023; 4.5 ± 1.4 vs. 3.0 ± 1.6 cm2, p = 0.035). The proportion of moderate‐to‐strong positive type II collagen staining was significantly higher in the hUCB‐MSC group compared to that in the microdrilled group (93.3% vs. 60%, respectively). Rigidity upon probing resembled that of normal cartilage tissue more in the hUCB‐MSC group (86.7% vs. 50.0%, p = 0.075). Histological findings revealed a higher proportion of hyaline cartilage in the group with implanted hUCB‐MSC (p = 0.041).
Conclusion
hUCB‐MSC implantation showed comparable clinical outcomes to those of microdrilling as supplementary cartilage procedures combined with HTO in the short term, despite the significantly larger cartilage defect in the hUCB‐MSC group. The repaired cartilage after hUCB‐MSC implantation showed greater hyaline‐type cartilage with rigidity than that after microdrilling.
Level of Evidence
Level II, Prospective Comparative Cohort Study. |
| doi_str_mv | 10.1002/ksa.12100 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2934277367</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2934277367</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2850-65e713108c5a317e34ec0c547a2e911f3c53a3fcb5881fc277a8a5cc8ef324393</originalsourceid><addsrcrecordid>eNp1kLtOwzAUhi0EouUy8ALIIwwB3xInY6m4CRADdI5c96QxJHGxXaEMSDwCz8iTYGhhY_r_4TufdH6EDig5oYSw02evTiiLdQMNqeA8kVzITTQkhWAJI2k2QDvePxESqyi20YDngmUZlUP0dt0uGtUFFYztsK1wPRmffb5_3D2MPZ5DB04FiM1BTIfrXjWmgwiEfgFYKxdMo-aAQ6063Brt7MyZJjJzrG07jewMv5pQ49rMaxzM1KgGWx_ABtv2e2irUo2H_XXuosnF-eP4Krm9v7wej24TzfKUJFkKknJKcp0qTiVwAZroVEjFoKC04jrlild6muY5rTSTUuUq1TqHijPBC76LjlbehbMvS_ChbI3X0MTPwS59yQou4hXPZESPV2h8xXsHVblwplWuLykpv9cu49rlz9qRPVxrl9MWZn_k77wROF0Br6aB_n9TefMwWim_AEDPjK0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2934277367</pqid></control><display><type>article</type><title>Implantation of hUCB‐MSCs generates greater hyaline‐type cartilage than microdrilling combined with high tibial osteotomy</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Jung, Se‐Han ; Park, Hyunjin ; Jung, Min ; Chung, Kwangho ; Kim, Sungjun ; Moon, Hyun‐Soo ; Park, Jisoo ; Lee, Ju‐Hyung ; Choi, Chong‐Hyuk ; Kim, Sung‐Hwan</creator><creatorcontrib>Jung, Se‐Han ; Park, Hyunjin ; Jung, Min ; Chung, Kwangho ; Kim, Sungjun ; Moon, Hyun‐Soo ; Park, Jisoo ; Lee, Ju‐Hyung ; Choi, Chong‐Hyuk ; Kim, Sung‐Hwan</creatorcontrib><description>Purpose
To compare the outcomes of treating large cartilage defects in knee osteoarthritis using human allogeneic umbilical cord blood‐derived mesenchymal stem cell (hUCB‐MSC) implantation or arthroscopic microdrilling as a supplementary cartilage regenerative procedure combined with high tibial osteotomy (HTO).
Methods
This 1‐year prospective comparative study included 25 patients with large, near full‐thickness cartilage defects (International Cartilage Repair Society grade ≥ IIIB) in the medial femoral condyles and varus malalignment. Defects were treated with hUCB‐MSC implantation or arthroscopic microdrilling combined with HTO. The primary outcomes were pain visual analogue scale and International Knee Documentation Committee subjective scores at 12, 24 and 48 weeks. Secondary outcomes included arthroscopic, histological and magnetic resonance imaging assessments at 1 year.
Results
Fifteen and 10 patients were treated via hUCB‐MSC implantation and microdrilling, respectively. Baseline demographics, limb alignment and clinical outcomes did not significantly differ between the groups. Cartilage defects and total restored areas were significantly larger in the hUCB‐MSC group (7.2 ± 1.9 vs. 5.2 ± 2.1 cm2, p = 0.023; 4.5 ± 1.4 vs. 3.0 ± 1.6 cm2, p = 0.035). The proportion of moderate‐to‐strong positive type II collagen staining was significantly higher in the hUCB‐MSC group compared to that in the microdrilled group (93.3% vs. 60%, respectively). Rigidity upon probing resembled that of normal cartilage tissue more in the hUCB‐MSC group (86.7% vs. 50.0%, p = 0.075). Histological findings revealed a higher proportion of hyaline cartilage in the group with implanted hUCB‐MSC (p = 0.041).
Conclusion
hUCB‐MSC implantation showed comparable clinical outcomes to those of microdrilling as supplementary cartilage procedures combined with HTO in the short term, despite the significantly larger cartilage defect in the hUCB‐MSC group. The repaired cartilage after hUCB‐MSC implantation showed greater hyaline‐type cartilage with rigidity than that after microdrilling.
Level of Evidence
Level II, Prospective Comparative Cohort Study.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1002/ksa.12100</identifier><identifier>PMID: 38426617</identifier><language>eng</language><publisher>Germany</publisher><subject>cartilage repair ; Cartilage, Articular - surgery ; Cohort Studies ; high tibial osteotomy ; Humans ; Hyalin ; Hyaline Cartilage ; knee osteoarthritis ; marrow stimulation ; mesenchymal stem cell ; Mesenchymal Stem Cell Transplantation - methods ; Osteoarthritis, Knee - surgery ; Osteotomy - methods ; Prospective Studies ; Treatment Outcome</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2024-04, Vol.32 (4), p.829-842</ispartof><rights>2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2850-65e713108c5a317e34ec0c547a2e911f3c53a3fcb5881fc277a8a5cc8ef324393</cites><orcidid>0000-0002-7876-7901 ; 0000-0001-8678-2960 ; 0000-0001-8422-093X ; 0000-0001-5743-6241 ; 0000-0002-7527-4802 ; 0000-0003-3097-3332 ; 0000-0002-9080-4904</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fksa.12100$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fksa.12100$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38426617$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Se‐Han</creatorcontrib><creatorcontrib>Park, Hyunjin</creatorcontrib><creatorcontrib>Jung, Min</creatorcontrib><creatorcontrib>Chung, Kwangho</creatorcontrib><creatorcontrib>Kim, Sungjun</creatorcontrib><creatorcontrib>Moon, Hyun‐Soo</creatorcontrib><creatorcontrib>Park, Jisoo</creatorcontrib><creatorcontrib>Lee, Ju‐Hyung</creatorcontrib><creatorcontrib>Choi, Chong‐Hyuk</creatorcontrib><creatorcontrib>Kim, Sung‐Hwan</creatorcontrib><title>Implantation of hUCB‐MSCs generates greater hyaline‐type cartilage than microdrilling combined with high tibial osteotomy</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
To compare the outcomes of treating large cartilage defects in knee osteoarthritis using human allogeneic umbilical cord blood‐derived mesenchymal stem cell (hUCB‐MSC) implantation or arthroscopic microdrilling as a supplementary cartilage regenerative procedure combined with high tibial osteotomy (HTO).
Methods
This 1‐year prospective comparative study included 25 patients with large, near full‐thickness cartilage defects (International Cartilage Repair Society grade ≥ IIIB) in the medial femoral condyles and varus malalignment. Defects were treated with hUCB‐MSC implantation or arthroscopic microdrilling combined with HTO. The primary outcomes were pain visual analogue scale and International Knee Documentation Committee subjective scores at 12, 24 and 48 weeks. Secondary outcomes included arthroscopic, histological and magnetic resonance imaging assessments at 1 year.
Results
Fifteen and 10 patients were treated via hUCB‐MSC implantation and microdrilling, respectively. Baseline demographics, limb alignment and clinical outcomes did not significantly differ between the groups. Cartilage defects and total restored areas were significantly larger in the hUCB‐MSC group (7.2 ± 1.9 vs. 5.2 ± 2.1 cm2, p = 0.023; 4.5 ± 1.4 vs. 3.0 ± 1.6 cm2, p = 0.035). The proportion of moderate‐to‐strong positive type II collagen staining was significantly higher in the hUCB‐MSC group compared to that in the microdrilled group (93.3% vs. 60%, respectively). Rigidity upon probing resembled that of normal cartilage tissue more in the hUCB‐MSC group (86.7% vs. 50.0%, p = 0.075). Histological findings revealed a higher proportion of hyaline cartilage in the group with implanted hUCB‐MSC (p = 0.041).
Conclusion
hUCB‐MSC implantation showed comparable clinical outcomes to those of microdrilling as supplementary cartilage procedures combined with HTO in the short term, despite the significantly larger cartilage defect in the hUCB‐MSC group. The repaired cartilage after hUCB‐MSC implantation showed greater hyaline‐type cartilage with rigidity than that after microdrilling.
Level of Evidence
Level II, Prospective Comparative Cohort Study.</description><subject>cartilage repair</subject><subject>Cartilage, Articular - surgery</subject><subject>Cohort Studies</subject><subject>high tibial osteotomy</subject><subject>Humans</subject><subject>Hyalin</subject><subject>Hyaline Cartilage</subject><subject>knee osteoarthritis</subject><subject>marrow stimulation</subject><subject>mesenchymal stem cell</subject><subject>Mesenchymal Stem Cell Transplantation - methods</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Osteotomy - methods</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtOwzAUhi0EouUy8ALIIwwB3xInY6m4CRADdI5c96QxJHGxXaEMSDwCz8iTYGhhY_r_4TufdH6EDig5oYSw02evTiiLdQMNqeA8kVzITTQkhWAJI2k2QDvePxESqyi20YDngmUZlUP0dt0uGtUFFYztsK1wPRmffb5_3D2MPZ5DB04FiM1BTIfrXjWmgwiEfgFYKxdMo-aAQ6063Brt7MyZJjJzrG07jewMv5pQ49rMaxzM1KgGWx_ABtv2e2irUo2H_XXuosnF-eP4Krm9v7wej24TzfKUJFkKknJKcp0qTiVwAZroVEjFoKC04jrlild6muY5rTSTUuUq1TqHijPBC76LjlbehbMvS_ChbI3X0MTPwS59yQou4hXPZESPV2h8xXsHVblwplWuLykpv9cu49rlz9qRPVxrl9MWZn_k77wROF0Br6aB_n9TefMwWim_AEDPjK0</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Jung, Se‐Han</creator><creator>Park, Hyunjin</creator><creator>Jung, Min</creator><creator>Chung, Kwangho</creator><creator>Kim, Sungjun</creator><creator>Moon, Hyun‐Soo</creator><creator>Park, Jisoo</creator><creator>Lee, Ju‐Hyung</creator><creator>Choi, Chong‐Hyuk</creator><creator>Kim, Sung‐Hwan</creator><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>7X8</scope><orcidid>https://orcid.org/0000-0002-7876-7901</orcidid><orcidid>https://orcid.org/0000-0001-8678-2960</orcidid><orcidid>https://orcid.org/0000-0001-8422-093X</orcidid><orcidid>https://orcid.org/0000-0001-5743-6241</orcidid><orcidid>https://orcid.org/0000-0002-7527-4802</orcidid><orcidid>https://orcid.org/0000-0003-3097-3332</orcidid><orcidid>https://orcid.org/0000-0002-9080-4904</orcidid></search><sort><creationdate>202404</creationdate><title>Implantation of hUCB‐MSCs generates greater hyaline‐type cartilage than microdrilling combined with high tibial osteotomy</title><author>Jung, Se‐Han ; Park, Hyunjin ; Jung, Min ; Chung, Kwangho ; Kim, Sungjun ; Moon, Hyun‐Soo ; Park, Jisoo ; Lee, Ju‐Hyung ; Choi, Chong‐Hyuk ; Kim, Sung‐Hwan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2850-65e713108c5a317e34ec0c547a2e911f3c53a3fcb5881fc277a8a5cc8ef324393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>cartilage repair</topic><topic>Cartilage, Articular - surgery</topic><topic>Cohort Studies</topic><topic>high tibial osteotomy</topic><topic>Humans</topic><topic>Hyalin</topic><topic>Hyaline Cartilage</topic><topic>knee osteoarthritis</topic><topic>marrow stimulation</topic><topic>mesenchymal stem cell</topic><topic>Mesenchymal Stem Cell Transplantation - methods</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Osteotomy - methods</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Se‐Han</creatorcontrib><creatorcontrib>Park, Hyunjin</creatorcontrib><creatorcontrib>Jung, Min</creatorcontrib><creatorcontrib>Chung, Kwangho</creatorcontrib><creatorcontrib>Kim, Sungjun</creatorcontrib><creatorcontrib>Moon, Hyun‐Soo</creatorcontrib><creatorcontrib>Park, Jisoo</creatorcontrib><creatorcontrib>Lee, Ju‐Hyung</creatorcontrib><creatorcontrib>Choi, Chong‐Hyuk</creatorcontrib><creatorcontrib>Kim, Sung‐Hwan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Se‐Han</au><au>Park, Hyunjin</au><au>Jung, Min</au><au>Chung, Kwangho</au><au>Kim, Sungjun</au><au>Moon, Hyun‐Soo</au><au>Park, Jisoo</au><au>Lee, Ju‐Hyung</au><au>Choi, Chong‐Hyuk</au><au>Kim, Sung‐Hwan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implantation of hUCB‐MSCs generates greater hyaline‐type cartilage than microdrilling combined with high tibial osteotomy</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2024-04</date><risdate>2024</risdate><volume>32</volume><issue>4</issue><spage>829</spage><epage>842</epage><pages>829-842</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
To compare the outcomes of treating large cartilage defects in knee osteoarthritis using human allogeneic umbilical cord blood‐derived mesenchymal stem cell (hUCB‐MSC) implantation or arthroscopic microdrilling as a supplementary cartilage regenerative procedure combined with high tibial osteotomy (HTO).
Methods
This 1‐year prospective comparative study included 25 patients with large, near full‐thickness cartilage defects (International Cartilage Repair Society grade ≥ IIIB) in the medial femoral condyles and varus malalignment. Defects were treated with hUCB‐MSC implantation or arthroscopic microdrilling combined with HTO. The primary outcomes were pain visual analogue scale and International Knee Documentation Committee subjective scores at 12, 24 and 48 weeks. Secondary outcomes included arthroscopic, histological and magnetic resonance imaging assessments at 1 year.
Results
Fifteen and 10 patients were treated via hUCB‐MSC implantation and microdrilling, respectively. Baseline demographics, limb alignment and clinical outcomes did not significantly differ between the groups. Cartilage defects and total restored areas were significantly larger in the hUCB‐MSC group (7.2 ± 1.9 vs. 5.2 ± 2.1 cm2, p = 0.023; 4.5 ± 1.4 vs. 3.0 ± 1.6 cm2, p = 0.035). The proportion of moderate‐to‐strong positive type II collagen staining was significantly higher in the hUCB‐MSC group compared to that in the microdrilled group (93.3% vs. 60%, respectively). Rigidity upon probing resembled that of normal cartilage tissue more in the hUCB‐MSC group (86.7% vs. 50.0%, p = 0.075). Histological findings revealed a higher proportion of hyaline cartilage in the group with implanted hUCB‐MSC (p = 0.041).
Conclusion
hUCB‐MSC implantation showed comparable clinical outcomes to those of microdrilling as supplementary cartilage procedures combined with HTO in the short term, despite the significantly larger cartilage defect in the hUCB‐MSC group. The repaired cartilage after hUCB‐MSC implantation showed greater hyaline‐type cartilage with rigidity than that after microdrilling.
Level of Evidence
Level II, Prospective Comparative Cohort Study.</abstract><cop>Germany</cop><pmid>38426617</pmid><doi>10.1002/ksa.12100</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-7876-7901</orcidid><orcidid>https://orcid.org/0000-0001-8678-2960</orcidid><orcidid>https://orcid.org/0000-0001-8422-093X</orcidid><orcidid>https://orcid.org/0000-0001-5743-6241</orcidid><orcidid>https://orcid.org/0000-0002-7527-4802</orcidid><orcidid>https://orcid.org/0000-0003-3097-3332</orcidid><orcidid>https://orcid.org/0000-0002-9080-4904</orcidid></addata></record> |
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| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2024-04, Vol.32 (4), p.829-842 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | cartilage repair Cartilage, Articular - surgery Cohort Studies high tibial osteotomy Humans Hyalin Hyaline Cartilage knee osteoarthritis marrow stimulation mesenchymal stem cell Mesenchymal Stem Cell Transplantation - methods Osteoarthritis, Knee - surgery Osteotomy - methods Prospective Studies Treatment Outcome |
| title | Implantation of hUCB‐MSCs generates greater hyaline‐type cartilage than microdrilling combined with high tibial osteotomy |
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