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Bone marrow aspirate, mesenchymal stem cells an alternative for chondral lesion treatment
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HOLLYWOOD, Fla. – Concentrated bone marrow aspirate with one-step implantation of mesenchymal stem cells can be a viable alternative in the treatment of grade IV chondral lesions of the knee, according to a study presented here.
Alberto W. Gobbi, MD, presented his group's findings at the 2010 Annual Meeting of the Arthroscopy Association of North America.
Gobbi said the procedure also offers the advantage of a lower cost when compared to more conventional methods.
“Our goal is to eliminate osteoarthritis in the future and to reduce the high cost of osteoarthritis,” he said.
Study parameters
Twenty-five patients with grade IV cartilage lesions of the knee were treated at Gobbi's institution, OASI Research Center in Milan, Italy, with mesenchymal stem cell implantation and prospectively followed up on for 24 months. The procedure itself involved a mini-arthrotomy approach with concentrated mesenchymal stem cells being pasted into the lesion and covered with a collagen membrane sutured to the surrounding tissue.
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All patients followed the same specific rehabilitation program for a minimum of 6 months, Gobbi said.
“A rehabilitation program … is very important to reduce pain and swelling,” he added.
Numerous scores were collected preoperatively and every 6 months postoperatively, as well as at the final follow-up. All patients underwent MRI at 6, 12 and 24 months.
A number of improvements
Patients showed improvements in their evaluation scores over the follow-up period, Gobbi said, with MRI showing good integration and coverage of the defect, as well as no reaction of subchondral bone.
Gobbi also reported a complete lack of adverse reactions or postoperative complications. Second-look arthroscopies and biopsies performed in four knees revealed the formation of good cartilage-type tissue with typical hyaline features, particularly at longer follow-up times.
“This is a new technique, but it is very user-friendly because it is easy to perform,” Gobbi concluded. “There are few clinical studies, but this is a low-cost technique.”
- Reference:
Gobbi AW, Boldrini L, Grigolo B, Mazzuco L. Concentrated bone marrow aspirate in cartilage repair. Paper SS-35. Presented at the 2010 Annual Meeting of the Arthroscopy Association of North America. May 20-23, 2010. Hollywood, Fla.
