Prognostic Factors for Clinical Outcome and Cartilage Regeneration after Implantation of Allogeneic Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells in Large-Sized Cartilage Defects with Osteoarthritis.

IF 2.7 4区医学 Q1 ORTHOPEDICS

CARTILAGE Pub Date : 2024-12-01 Epub Date: 2024-02-16 DOI:10.1177/19476035241231372

Se-Han Jung, Min Jung, Kwangho Chung, Sungjun Kim, Jisoo Park, Junseok Hong, Chong-Hyuk Choi, Sung-Hwan Kim

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Abstract

Objective: To analyze the prognostic factors for clinical outcomes and cartilage regeneration after the implantation of allogeneic human umbilical cord blood mesenchymal stem cell (hUCB-MSC) for treating large-sized cartilage defects with osteoarthritis.

Design: This study is a case-series with multiple subgroup analyses that divides the included patients into multiple subgroups based on various factors. Overall, 47 patients who underwent hUCB-MSC implantation were included. The patient-reported outcomes, magnetic resonance imaging (MRI), and second-look arthroscopy were used to assess the outcomes.

Results: Combined realignment surgery significantly correlated with clinical outcomes, particularly pain. No other factors significantly influenced the clinical outcomes in short-term period. Subgroups with large defect sizes or meniscal insufficiency showed significantly poor MRI and arthroscopy outcomes (MRI, P = 0.001, P = 0.001; arthroscopy, P = 0.032, P = 0.042). The logistic regression showed that patients with a 1 cm² larger defect size were 1.91 times less likely to achieve favorable MRI outcomes (P = 0.017; odds ratio [OR], 1.91). Cut-off value to predict the poor outcome was >5.7 cm² (area under the curve, 0.756). A cartilage defect size >5.7 cm² was the major poor prognostic factor for cartilage regeneration on MRI (P = 0.010; OR, 17.46). If the postoperative alignment shifted by 1° opposite to the cartilage defect, it was 1.4 times more likely to achieve favorable MRI outcomes (P = 0.028; OR, 1.4).

Conclusion: Combining realignment surgery showed a better prognosis for pain improvement. Cartilage defect size, meniscal function, and postoperative alignment are significant prognostic factors for cartilage regeneration. A cartilage defect size >5.7 cm² was significantly related to poor cartilage regeneration.

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同种异体人类脐带血间充质干细胞植入大面积软骨缺损伴骨关节炎患者后的临床结果和软骨再生的预后因素。

目的分析异体人脐血间充质干细胞（hUCB-MSC）植入治疗骨关节炎大面积软骨缺损后临床疗效和软骨再生的预后因素：本研究是一项病例系列研究，根据各种因素将纳入的患者分为多个亚组进行分析。共有47名患者接受了hUCB-间充质干细胞植入术。患者报告的结果、磁共振成像（MRI）和二次关节镜检查用于评估结果：结果：联合复位手术与临床结果，尤其是疼痛有明显相关性。结果：联合复位手术与临床疗效有明显相关性，尤其是疼痛，其他因素对短期临床疗效无明显影响。缺损面积大或半月板功能不全的亚组在核磁共振成像和关节镜检查中的疗效明显较差（核磁共振成像，P = 0.001，P = 0.001；关节镜检查，P = 0.032，P = 0.042）。逻辑回归结果显示，缺损面积大于 1 平方厘米的患者获得良好 MRI 结果的几率要低 1.91 倍（P = 0.017；几率比 [OR]，1.91）。预测不良结果的临界值为 >5.7 平方厘米（曲线下面积为 0.756）。软骨缺损面积大于 5.7 平方厘米是核磁共振成像显示软骨再生不良预后的主要因素（P = 0.010；OR，17.46）。如果术后对位向软骨缺损相反方向移动1°，则获得良好磁共振成像结果的可能性增加1.4倍（P = 0.028；OR，1.4）：结论：结合复位手术能更好地改善疼痛。软骨缺损大小、半月板功能和术后对位是软骨再生的重要预后因素。软骨缺损面积大于5.7平方厘米与软骨再生不良有显著关系。

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来源期刊

CARTILAGE ORTHOPEDICS-

CiteScore

6.90

自引率

7.10%

发文量

期刊介绍： CARTILAGE publishes articles related to the musculoskeletal system with particular attention to cartilage repair, development, function, degeneration, transplantation, and rehabilitation. The journal is a forum for the exchange of ideas for the many types of researchers and clinicians involved in cartilage biology and repair. A primary objective of CARTILAGE is to foster the cross-fertilization of the findings between clinical and basic sciences throughout the various disciplines involved in cartilage repair. The journal publishes full length original manuscripts on all types of cartilage including articular, nasal, auricular, tracheal/bronchial, and intervertebral disc fibrocartilage. Manuscripts on clinical and laboratory research are welcome. Review articles, editorials, and letters are also encouraged. The ICRS envisages CARTILAGE as a forum for the exchange of knowledge among clinicians, scientists, patients, and researchers. The International Cartilage Repair Society (ICRS) is dedicated to promotion, encouragement, and distribution of fundamental and applied research of cartilage in order to permit a better knowledge of function and dysfunction of articular cartilage and its repair.