Articular Cartilage Regeneration With Autologous Peripheral Blood Progenitor Cells and Hyaluronic Acid After Arthroscopic Subchondral Drilling: A Report of 5 Cases With Histology

Autor: Shahrin Merican, Yong-Guan Tay, David A. McGuire, Caroline Siew-Yoke Jee, Adam W. Anz, Khay-Yong Saw, Kunaseegaran Ragavanaidu
Rok vydání: 2011
Předmět:
Adult
Cartilage
Articular
Male
musculoskeletal diseases
medicine.medical_specialty
Adolescent
Filgrastim
Knee Joint
Arthroplasty
Subchondral
medicine.medical_treatment
Pilot Projects
Knee Injuries
Transplantation
Autologous
Continuous passive motion
Injections
Intra-Articular
Young Adult
chemistry.chemical_compound
Granulocyte Colony-Stimulating Factor
Hyaluronic acid
Humans
Regeneration
Medicine
Orthopedics and Sports Medicine
Hyaluronic Acid
Cryopreservation
Peripheral Blood Stem Cell Transplantation
medicine.diagnostic_test
business.industry
Hyaline cartilage
Cartilage
Arthroscopy
Motion Therapy
Continuous Passive
Middle Aged
musculoskeletal system
Combined Modality Therapy
Arthroplasty
Hematopoietic Stem Cell Mobilization
Recombinant Proteins
Surgery
Transplantation
medicine.anatomical_structure
chemistry
Second-Look Surgery
Blood Component Removal
Female
business
Zdroj: Arthroscopy: The Journal of Arthroscopic & Related Surgery. 27:493-506
ISSN: 0749-8063
DOI: 10.1016/j.arthro.2010.11.054
Popis: Purpose The purpose of this study was to evaluate the quality of articular cartilage regeneration after arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous peripheral blood progenitor cells (PBPCs) in combination with hyaluronic acid (HA). Methods Five patients underwent second-look arthroscopy with chondral core biopsy. These 5 patients are part of a larger pilot study in which 180 patients with International Cartilage Repair Society grade III and IV lesions of the knee joint underwent arthroscopic subchondral drilling followed by postoperative intra-articular injections. Continuous passive motion was used on the operated knee 2 hours per day for 4 weeks. Partial weight bearing was observed for the first 6 to 8 weeks. Autologous PBPCs were harvested 1 week after surgery. One week after surgery, 8 mL of the harvested PBPCs in combination with 2 mL of HA was injected intra-articularly into the operated knee. The remaining PBPCs were divided into vials and cryopreserved. A total of 5 weekly intra-articular injections were given. Results Second-look arthroscopy confirmed articular cartilage regeneration, and histologic sections showed features of hyaline cartilage. Apart from the minimal discomfort of PBPC harvesting and localized pain associated with the intra-articular injections, there were no other notable adverse reactions. Conclusions Articular hyaline cartilage regeneration is possible with arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous PBPCs in combination with HA. Level of Evidence Level IV, therapeutic case series.
Databáze: OpenAIRE
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