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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

Authors
 Se-Han Jung  ;  Min Jung  ;  Kwangho Chung  ;  Sungjun Kim 5, Jisoo Park  ;  Junseok Hong  ;  Chong-Hyuk Choi  ;  Sung-Hwan Kim 
Citation
 CARTILAGE, Vol.15(4) : 375-388, 2024-12 
Journal Title
CARTILAGE
ISSN
 1947-6035 
Issue Date
2024-12
MeSH
Adult ; Aged ; Arthroscopy* / methods ; Cartilage, Articular* / surgery ; Cord Blood Stem Cell Transplantation / methods ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Mesenchymal Stem Cell Transplantation* / methods ; Middle Aged ; Osteoarthritis, Knee / surgery ; Prognosis ; Regeneration* / physiology ; Treatment Outcome
Keywords
cartilage defect ; cartilage repair ; mesenchymal stem cell ; osteoarthritis ; stem cell therapy
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.
Files in This Item:
T202406870.pdf Download
DOI
10.1177/19476035241231372
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 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
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/22282913/201306
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