2015 ISAKOS Biennial Congress ePoster #909

Use of Expanded Autologous MSC (Mesenchymal Stem Cells) Injections After Complex Cartilage FAI Hip Scope Procedure. 1 To 2.5 Years Follow-Up

Rodrigo Mardones, MD, Santiago CHILE
Jose Leonardo Tovar Curieux, MD, Santiago De Chile CHILE
Alexander Tomic, MD, Santiago CHILE
Matias Salineros, MD, Santiago CHILE

clinica las condes, Santiago , CHILE

The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use:

Summary: Retrospective analysis of functional outcomes of complex/advanced cartilage FAI derived Hip problems after Hip arthroscopy treatment and use of autologous expanded MSC (Mesenchymal Stem Cells) post op injections.

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Abstract:

Introduction

Complex/advanced cartilage FAI / Hip problems include any of the following criteria: patients with age over 50, diffuse cartilage damage (DJD), less than 2 mm joint space at same area on x-ray, or younger patients with important (>2cm2) grade IV chondral lesion. Historically, in our hands, these patients had over 20% failure rate (THA) at one-year follow-up. Since 2012, we started to use expanded MSC injections 4-6 weeks after surgery in order to improve the clinical outcome and reduce the failure rate on this specific group. We retrospectively reviewed the results of patients with at least one-year follow-up.

Objective

Evaluate the functional outcome and potential complications of complex / advanced cartilage FAI / Hip problems arthroscopically treated plus the complementary injections of expanded MSC 4 to 6 weeks after surgery.

MATERIAL & METHOD
We retrospectively reviewed data from patients that received autologous expanded MSC (3 injections of 20x106 cells one week apart 4 to 6 weeks after surgery). Complex/advanced cartilage FAI / Hip problems were considered with any of the following criteria: age over 50, diffuse cartilage damage (DJD), less than 2 mm joint space on x-ray important (>2cm2) grade IV chondral lesion. 13 hips met these criteria. Short term complications after the injection (infection / pain / arthritis) and pre and last post op WOMAC / HOSS / mHHS were evaluated in patients with at least one year follow up. We compared this with a similar historical control of 20 patients with similar complex pathology treated without MSC.

Results

Average preop WOMAC / HOOS / mHHS were 89.1 69, 71 and increased with significant differences to 74; 91,3; and 95.7 respectively. There were no infections or major complications after any of the 3 injections per patient. 2 patients had important pain 1-5 days after the second or third injection, all managed by oral pain medication. There was no failure (THA) after at least one year or latest follow-up. 1 patient required a second cycle of injections 2 years after the hip scope and showed pain relief up to last follow up (8 month)

Conclusion

The use of autologous MSC in 3 injections of 20 x 106 cells in combination with Hip Arthroscopy treatment improve the quality of life and functional score, and decrease the failure rate at one year follow-up (historical >20%), in patients with complex/advanced cartilage FAI derived hip problems with no major complication.