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Implantation of hUCB-MSCs generates greater hyaline-type cartilage than microdrilling combined with high tibial osteotomy

Authors
 Se-Han Jung  ;  Hyunjin Park  ;  Min Jung  ;  Kwangho Chung  ;  Sungjun Kim  ;  Hyun-Soo Moon  ;  Jisoo Park  ;  Ju-Hyung Lee  ;  Chong-Hyuk Choi  ;  Sung-Hwan Kim 
Citation
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol.32(4) : 829-842, 2024-04 
Journal Title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
ISSN
 0942-2056 
Issue Date
2024-04
MeSH
Cartilage, Articular* / surgery ; Cohort Studies ; Humans ; Hyalin ; Hyaline Cartilage ; Mesenchymal Stem Cell Transplantation* / methods ; Osteoarthritis, Knee* / surgery ; Osteotomy / methods ; Prospective Studies ; Treatment Outcome
Keywords
cartilage repair ; high tibial osteotomy ; knee osteoarthritis ; marrow stimulation ; mesenchymal stem cell
Abstract
PURPOSE: To compare the outcomes of treating large cartilage defects in knee osteoarthritis using human allogeneic umbilical cord blood-derived mesenchymal stem cell (hUCB-MSC) implantation or arthroscopic microdrilling as a supplementary cartilage regenerative procedure combined with high tibial osteotomy (HTO). METHODS: This 1-year prospective comparative study included 25 patients with large, near full-thickness cartilage defects (International Cartilage Repair Society grade >/= IIIB) in the medial femoral condyles and varus malalignment. Defects were treated with hUCB-MSC implantation or arthroscopic microdrilling combined with HTO. The primary outcomes were pain visual analogue scale and International Knee Documentation Committee subjective scores at 12, 24 and 48 weeks. Secondary outcomes included arthroscopic, histological and magnetic resonance imaging assessments at 1 year. RESULTS: Fifteen and 10 patients were treated via hUCB-MSC implantation and microdrilling, respectively. Baseline demographics, limb alignment and clinical outcomes did not significantly differ between the groups. Cartilage defects and total restored areas were significantly larger in the hUCB-MSC group (7.2 +/- 1.9 vs. 5.2 +/- 2.1 cm(2), p = 0.023; 4.5 +/- 1.4 vs. 3.0 +/- 1.6 cm(2), p = 0.035). The proportion of moderate-to-strong positive type II collagen staining was significantly higher in the hUCB-MSC group compared to that in the microdrilled group (93.3% vs. 60%, respectively). Rigidity upon probing resembled that of normal cartilage tissue more in the hUCB-MSC group (86.7% vs. 50.0%, p = 0.075). Histological findings revealed a higher proportion of hyaline cartilage in the group with implanted hUCB-MSC (p = 0.041). CONCLUSION: hUCB-MSC implantation showed comparable clinical outcomes to those of microdrilling as supplementary cartilage procedures combined with HTO in the short term, despite the significantly larger cartilage defect in the hUCB-MSC group. The repaired cartilage after hUCB-MSC implantation showed greater hyaline-type cartilage with rigidity than that after microdrilling. LEVEL OF EVIDENCE: Level II, Prospective Comparative Cohort Study.
Full Text
https://esskajournals.onlinelibrary.wiley.com/doi/full/10.1002/ksa.12100
DOI
10.1002/ksa.12100
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Moon, Hyun-Soo(문현수)
Park, Hyunjin(박현진)
Chung, Kwangho(정광호) ORCID logo https://orcid.org/0000-0003-3097-3332
Jung, Min(정민) ORCID logo https://orcid.org/0000-0002-7527-4802
Jung, Se-Han(정세한) ORCID logo https://orcid.org/0000-0001-8422-093X
Choi, Chong Hyuk(최종혁) ORCID logo https://orcid.org/0000-0002-9080-4904
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198872
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