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- Title
Intra-articular injection of culture-expanded mesenchymal stem cells with or without addition of platelet-rich plasma is effective in decreasing pain and symptoms in knee osteoarthritis: a controlled, double-blind clinical trial.
- Authors
Bastos, Ricardo; Mathias, Marcelo; Andrade, Renato; Amaral, Ronaldo J. F. C.; Schott, Vinicius; Balduino, Alex; Bastos, Raquel; Miguel Oliveira, J.; Reis, Rui L.; Rodeo, Scott; Espregueira-Mendes, João
- Abstract
<bold>Purpose: </bold>To compare the clinical and laboratory outcomes of intra-articular injections of culture-expanded bone-derived mesenchymal stem cells (MSCs) with or without platelet-rich plasma (PRP) to intra-articular corticosteroid injections for the treatment of knee osteoarthritis (OA).<bold>Methods: </bold>Forty-seven patients with radiographic and symptomatic knee OA were randomized into three groups for intra-articular injections: autologous bone marrow-derived culture-expanded MSCs (n = 16); autologous bone marrow-derived culture-expanded MSCs + PRP (n = 14); and corticosteroid (n = 17). The outcomes were assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and range of motion (ROM) at baseline, 1, 2, 3, 6, 9 and 12 months and intra-articular cytokines analysis at baseline, 6 and 12 months postoperatively.<bold>Results: </bold>The three groups showed significant improvement in most KOOS domains and global score at 1st month and all domains and global score at 12-month follow-up (p < 0.05). At the 1st month, only the MSCs group showed significant differences in KOOS symptoms domain (p = 0.003). The MSCs and MSCs + PRP groups showed the highest percentage of improvement in most KOOS domains and global score compared to the corticosteroid group. All three groups showed a significant reduction in intra-articular levels of human interleukin-10 cytokine, from baseline to 12 months (p < 0.05).<bold>Conclusion: </bold>An intra-articular injection of bone marrow-derived culture-expanded MSCs with or without the addiction of PRP is effective in improving the function and decreasing symptoms caused by knee OA at 12-month follow-up.<bold>Level Of Evidence: </bold>II.
- Subjects
INTRA-articular injections; MESENCHYMAL stem cells; PLATELET-rich plasma; TOTAL knee replacement; CLINICAL trials; STEM cell transplantation; PAIN management; KNEE diseases; CYTOKINES; RESEARCH; PAIN measurement; RANGE of motion of joints; ADRENOCORTICAL hormones; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; TREATMENT effectiveness; COMPARATIVE studies; RANDOMIZED controlled trials; OSTEOARTHRITIS; BLIND experiment
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2020, Vol 28, Issue 6, p1989
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-019-05732-8