Summary
Patellofemoral joint is the site of knee which shows slower healing rate after cartilage restoration procedures using stem cells
Abstract
Purpose
The purpose of this prospective case series study was to compare the clinical results after matrix-induced autologous mesenchymal stem cells (MSCs) implantation between patients with patellofemoral joint cartilage lesions and patients with femoral condyles lesions.
Methods
30 ICRS grade 3 and 4 cartilage lesions (mean size 4.9 cm2) in 28 patients (17 male and 11 female) (mean age 29.06 years) were treated with a single-staged procedure involved filling of each defect with autologous culture-expanded AD-MSCs embedded in a trimmed-to-fit biodegradable matrix. The patients were followed at 1st, 3rd, 6th,12th, 24th and 36th p.o. month (mean 35.6 months) and their outcome analysis was based on the Knee injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) forms. The patients were divided in 2 groups according to the site of chondral lesions, (A) at the patellofemoral joint (N=9), and (B) at the femoral condyles (N=19), whereas the repeated measures ANOVA was used (p<0.05). ?he patients underwent MRI scanning every p.o. year, evaluated through MOCART score.
Results
The results indicated significant change over time for the IKDC scale and all KOOS subscales (p<0.001). Post hoc testing confirmed significant changes between all time points of measurements (p<0.001). When comparing group A and B there were significant difference in the mean values in IKDC (p=0.05): group A M=50.9, SD=10.8 and group B M=60.1, SD=13.8, in Pain subscale (p=0.007): group A (M=71.6, SD=9.3) and group B (M=81.2, SD=10.4), in Symptoms subscale (p=0.032): group A (M=72.8, SD=6.5) and group B (M=79.7, SD=10.5), and in ADL subscale (p=0.035): group A (M=70.4, SD=10.1) and group B (M=80.1, SD=13.7).
Conclusions
This study has shown significant improvement for both patellofemoral joint and femoral condyles lesions over time, however the patellofemoral joint lesions showed slower improvement rhythm and lower level of clinical scores values.
Key words: Cartilage Lesions, Mesenchymal Stem Cells, Patellofemoral Joint