One-step surgery with multipotent stem cells and Hyaluronan-based scaffold for the treatment of full-thickness chondral defects of the knee in patients older than 45 years

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Alberto GobbiGiuseppe M Peretti

Abstract

The aim of this study is to prospectively evaluate the medium-term effectiveness and regenerative capability of autologous adult mesenchymal stem cells, harvested as bone marrow aspirate concentrate (BMAC), along with a hyaluronan-based scaffold (Hyalofast) in the treatment of ICRS grade 4 chondral lesions of the knee joint, in patients older than 45 years. A study group of 20 patients with an age >45 years (mean 50.0 ± 4.1 years) was compared to a control group of 20 patients with an age <45 years (mean 36.6 ± 5.0). Patients were prospectively evaluated for 4 years. All patients were evaluated with MRI, KOOS, IKDC, VAS and Tegner scores preoperatively and at two-year and final follow-up. At final follow-up, all scores significantly improved (P < 0.001) as follows: all KOOS score categories; Tegner 2 (range 0-4) to 6 (range 4-8) and 3 (range 0-6) to 6 (range 3-10); IKDC subjective (39.2 ± 16.5 to 82.2 ± 8.9) and (40.8 ± 13.9 to 79.4 ± 14.6), in the study and control group respectively. In addition, we show that results are affected by lesion size and number but not from concomitant surgical procedures. MRI showed complete filling in 80 % of patients in the study group and 71 % of patients in the control group. Histological anal...Continue Reading

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Citations

Jul 6, 2016·Frontiers in Surgery·James HoltonMartin Snow
Oct 17, 2017·Current Opinion in Rheumatology·Shigeru Miyaki, Martin K Lotz
Nov 14, 2019·International Journal of Molecular Sciences·Fabio S M YamaguchiRoberta S Stilhano
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Mar 20, 2021·Journal of Tissue Engineering·Mahsa Nouri BarkestaniSara Shamdani
May 1, 2021·Indian Journal of Orthopaedics·Silvampatti Ramasamy SundararajanShanmuganathan Rajasekaran
Aug 7, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Derrick M KnapikBrian J Cole
Sep 3, 2021·Journal of Orthopaedic Surgery and Research·Filippo MiglioriniNicola Maffulli
Aug 4, 2020·Zeitschrift für Orthopädie und Unfallchirurgie·Philip Peter RoesslerFrank Alexander Schildberg

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Methods Mentioned

BETA
biopsy
biopsies

Software Mentioned

Stata
MedCalc
Tegner
SAS
SPSS
Systat
R environment

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