Χρήση αυτόλογων μεσεγχυματικών κυττάρων για την αντιμετώπιση χόνδρινων βλαβών του γόνατος ; The use of autologous mesenchymal stem cells for knee cartilage repair

Purpose. The present study aims to evaluate the efficacy of matrix-induced adipose-derived mesenchymal stem cells (AD-MSCs) for cartilage repair of focal, full-thickness, symptomatic chondral knee lesions.Materials and Methods. Twenty-five consecutive patients were initially treated for symptomatic full-thickness chondral defects of the knee and then prospectively followed for three years. All patients underwent a single-stage procedure consisting in filling each defect with autologous culture-expanded mesenchymal stem cells embedded in a trimmed-to-fit commercially available biodegradable matrix. Knee-related function was evaluated based on objective and subjective assessment tools using two self-reported questionnaires the KOOS and the IKDC, the objective form of IKDC, the Tegner activity level, the Visual Analogue Scale for pain. MRI data were analysed based on the MOCART scoring system.Results. The data analysis recorded a constantly increased statistically significant improvement in all the values of the KOOS subgroups as well as of the IKDC score post-operatively (p<0.05). Equally, the VAS score for pain and the IKDC objective evaluation were improved significantly as well (p<0.05). The Tegner activity score was also increased with statistically significant difference (p<0.05), nevertheless its initial decrease. The MRI findings demonstrate a complete filling of the defect and a complete integration to border zone in 65% of the patients. All patients were found with subchondral laminar changes. No treatment-related adverse events or complications were reported.Conclusions. Matrix-induced adipose-derived mesenchymal stem cells implantation is an effective and safe single-staged cell-based procedure to manage full-thickness focal chondral lesions of the knee. Our findings demonstrate that all patients presented significant clinical and functional improvement at 3 years follow-up. The MRI aspects of the repair tissue continue to progress during the first two years after the surgery. ; Σκοπός. Σκοπός ...