关节镜在关节内脂肪组织源性间充质干细胞治疗早期膝关节骨关节炎中的作用：一项双中心回顾性比较研究

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-07-21 DOI:10.1002/jeo2.70368

Simone Giusti, Ezio Adriani, Kristian Samuelsson, Alice Laudisio, Alexandra Horvath, Biagio Zampogna, Rocco Papalia

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引用次数: 0

摘要

目的：确定接受关节内脂肪源性间充质间质细胞（AD-MSCs）单独治疗膝关节骨性关节炎（OA）的患者与接受关节镜清创和灌洗后相同治疗的患者的临床评分和再干预率的差异。方法回顾两家骨科中心的内部记录，纳入2017-2018年期间所有连续接受关节内AD-MSC治疗的kelgren - lawrence II-III型膝关节OA患者。根据患者是否接受清创关节镜检查，将患者分为两组。通过Western Ontario和McMaster university骨关节炎指数（WOMAC）和视觉模拟量表（VAS）评分以及关节内AD-MSC注射后5年的再干预率对患者进行评估。结果共纳入135例患者，其中男性66例（49%），女性69例（51%）。干预时的平均年龄为66岁（43-81岁）。大约一半的队列（n = 68）在相同的环境下接受了诊断和治疗性关节镜（干预）手术，而另一半（n = 67）在没有关节镜手术的情况下接受了关节内AD-MSCs（对照组）。总的来说，94%的患者术后VAS评分有所改善。72例（53%）患者在关节内注射AD-MSCs后5年症状控制良好（VAS评分范围0-3）。在该组中，57%的患者还接受了关节镜检查作为治疗的一部分，而其余患者仅接受了关节内注射AD-MSCs。总体而言，在5年随访期间接受清创关节镜检查的队列中，WOMAC（关节镜+ AD-MSC 46分，AD-MSC 58分，p < 0.0001）和功能（关节镜+ AD-MSC 34分，AD-MSC 43分，p < 0.0001）评分更优。保守的再干预率，如透明质酸注射，在队列中是相当的。总的来说，在Kellgren-Lawrence I-III型膝关节炎中，清创关节镜联合AD-MSC优于单独的MSC。证据等级III级，回顾性比较研究。

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The role of arthroscopy in intra-articular adipose tissue-derived mesenchymal stem cells for the treatment of early-stage knee osteoarthritis: A bicentric retrospective comparative study

Purpose

To determine the difference in clinical scores and re-intervention rates in patients receiving intra-articular adipose-derived mesenchymal stromal cells (AD-MSCs) as a stand-alone treatment for knee osteoarthritis (OA) compared to patients receiving the same treatment following arthroscopic debridement and lavage.

Methods

Internal records at two orthopaedic centres were reviewed, and all consecutive patients with Kellgren–Lawrence II–III knee OA who had received intra-articular AD-MSC during 2017–2018 were included. The patients were stratified into two cohorts depending on whether they also received debridement arthroscopy. Patients were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) scores as well as re-intervention rates with a last available follow-up of 5 years after the intra-articular AD-MSC injection.

Results

A total of 135 patients were enroled, 66 (49%) patients were male and 69 (51%) were female. The mean age at the time of intervention was 66 (range: 43–81) years. About half of the cohort (n = 68) received a diagnostic and therapeutic arthroscopy (intervention) procedure in the same setting, whereas the other half (n = 67) received intra-articular AD-MSCs without an arthroscopic procedure (control). Totally, 94% reported improved VAS scores post-operatively. Seventy-two patients (53%) had good symptomatic control at 5 years after the intra-articular AD-MSCs injection (VAS score range 0–3). Within this group, 57% of the patients had also received arthroscopy as part of their treatment, whereas the remaining patients had only received the intra-articular injection of AD-MSCs. Overall, WOMAC (46 arthroscopy + AD-MSC, 58 AD-MSC, p < 0.0001) and functionality (34 arthroscopy + AD-MSC, 43 AD-MSC, p < 0.0001) scores were superior in the cohort who also received debridement arthroscopy at the 5-year follow-up. Conservative re-intervention rates, such as hyaluronic acid injections, were comparable amongst the cohorts.