Micro-fragmented stromal-vascular fraction plus microfractures provides better clinical results than microfractures alone in symptomatic focal chondral lesions of the knee
| Autor: | Gabriele Bernardi, Cosimo Tudisco, Susanna M Pagnotta, Salvatore Bisicchia |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Cartilage Articular Male medicine.medical_specialty Chondral lesion WOMAC Arthroplasty Subchondral Analgesic Knee Injuries Mesenchymal Stem Cell Transplantation Injections Intra-Articular Adipose-derived mesenchymal stem cell Knee Stromal-vascular fraction 03 medical and health sciences 0302 clinical medicine Settore MED/33 - Malattie Apparato Locomotore medicine Clinical endpoint Humans Orthopedics and Sports Medicine In patient Adverse effect Aged 030222 orthopedics business.industry 030229 sport sciences Middle Aged Stromal vascular fraction Surgery Treatment Outcome Adipose Tissue Orthopedic surgery Female business Cartilage Diseases Oxford knee score |
| Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 28:1876-1884 |
| ISSN: | 1433-7347 0942-2056 |
| Popis: | To evaluate clinical outcomes over a 1-year period in patients affected by symptomatic focal chondral lesions of the knee treated with micro-fragmented stromal-vascular fraction plus microfractures compared to microfractures alone. Two groups of 20 patients were arthroscopically treated with microfractures for a symptomatic focal chondral defect of the knee. At the end of surgery, in the experimental group, micro-fragmented stromal-vascular fraction was injected into the joint. Primary end point was WOMAC score at 12 months. Secondary end points were any adverse events, Oxford Knee Score, EQ-5D score, VAS for pain, analgesic and anti-inflammatory consumption. All the patients were evaluated at 12-month follow-up. No adverse reactions were noted. Analgesic and anti-inflammatory consumption was similar in both groups. At 1-month follow-up, no differences were noted between groups when compared to pre-operative scores. At 3-month follow-up, patients in both groups improved from the baseline in all variables. Significantly lower VAS scores were found in the experimental group (4.2 ± 3.2 vs. 5.9 ± 1.7, p = 0.04). At 6- and 12-month follow-ups, patients in the experimental group scored better in all outcomes with a moderate effect size; in particular, better WOMAC scores were obtained at 12 months, achieving the primary end-point of the study (17.7 ± 11.1 vs. 25.5 ± 12.7; p = 0.03). Injection of micro-fragmented stromal-vascular fraction is safe and, when associated with microfractures, is more effective in clinical terms than microfractures alone in patients affected by symptomatic focal chondral lesions of the knee. Results of the current study provide information that could help physicians to improve their counseling for patients concerning ADMSCs. Level 1—therapeutic study. |
| Databáze: | OpenAIRE |
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