Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2019.60.227
Early results of intra-articular micro-fragmented lipoaspirate treatment in patients with late stages knee osteoarthritis: a prospective study
Damir Hudetz
orcid.org/0000-0003-0883-2525
; University Hospital Sveti Duh, Zagreb, Croatia
Igor Borić
; Department of Radiology, St. Catherine Special Hospital, Zabok/Zagreb, Croatia
Eduard Rod
; Department of Orthopedics, St. Catherine Hospital, Zabok/Zagreb,Croatia
Željko Jeleč
; Department of Orthopedics, St. Catherine Hospital, Zabok/Zagreb,Croatia
Barbara Kunovac
; Department of Orthopedics, St. Catherine Hospital, Zabok/Zagreb,Croatia
Ozren Polašek
; Department of Public Health, School of Medicine, University of Split, Split, Croatia
Trpimir Vrdoljak
; Specialty Hospital St. Catherine, Croatia
Mihovil Plečko
; Specialty Hospital St. Catherine, Croatia
Andrea Skelin
; Specialty Hospital St. Catherine, Croatia
Denis Polančec
; Srebrnjak Children’s Hospital, Zagreb, Croatia
Lucija Zenić
; Srebrnjak Children’s Hospital, Zagreb, Croatia
Dragan Primorac
; Srebrnjak Children’s Hospital, Zagreb, Croatia
Sažetak
Aim To analyze clinical and functional effects of intra-articular
injection of autologous micro-fragmented lipoaspirate
(MLA) in patients with late stage knee osteoarthritis
(KOA). Secondary aims included classifying cell types contributing
to the treatment effect, performing detailed MRIbased
classification of KOA, and elucidating the predictors
for functional outcomes.
Methods This prospective, non-randomized study was
conducted from June 2016 to February 2018 and enrolled
20 patients with late stage symptomatic KOA (Kellgren
Lawrence grade III, n = 4; and IV, n = 16) who received an
intra-articular injection of autologous MLA in the index
knee joint. At baseline radiological KOA grade and MRI
were assessed in order to classify the morphology of KOA
changes. Stromal vascular fraction cells obtained from
MLA samples were stained with antibodies specific for cell
surface markers. Patients were evaluated at baseline and
12-months after treatment with visual analog scale (VAS),
Western Ontario and McMaster Universities Osteoarthritis
Index (WOMAC), and Knee Injury and Osteoarthritis Outcome
Score (KOOS).Results Three patients (15%) received a total knee replacement
and were not followed up completely. Seventeen
patients (85%) showed a substantial pattern of KOOS and
WOMAC improvement, significant in all accounts. KOOS
score improved from 46 to 176% when compared with
baseline, WOMAC decreased from 40 to 45%, while VAS rating
decreased from 54% to 82% (all P values were <0.001).
MLA contained endothelial progenitor cells, pericytes, and
supra-adventitial adipose stromal cells as most abundant
cell phenotypes.
Conclusion This study is among the first to show a positive
effect of MLA on patients with late stages KOA.
Ključne riječi
Hrčak ID:
240033
URI
Datum izdavanja:
15.6.2019.
Posjeta: 807 *