2017 ISAKOS Biennial Congress ePoster #602
Intra-Articular Infusion of Bone Marrow-Derived Mesenchymal Stem Cells to Patients Suffering Hip Osteoarthritis
Rodrigo M. Mardones, MD, Santiago CHILE
Daniel R. Camacho, MD, Santiago, RM CHILE
Claudio Jofre, PhD, Santiago CHILE
Jose Minguell, PhD, Santiago CHILE
Clinica Las Condes, Santiago, RM, 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:
In patients suffering hip osteoarthritis, the intra-articular injection of ex vivo expanded autologous bone marrow-derived mesenchymal stem cells embodies a feasible, safe and effective procedure for reducing pain and improve the function of the hip joint
Osteoarthritis (OA) embodies a recurrent and incapacitating arthritic condition, characterized by the occurrence of damaging joint changes, including cartilage destruction by cytokines, matrix metalloproteinase and prostaglandins. As a consequence, a cascade of deleterious events start. Adult bone marrow derived-mesenchymal stem cells (BM-MSC) fulfill the above requirements. In addition to differentiate into chondrocytes (which in turn produce and maintain a cartilaginous matrix), BM-MSC produce and secrete a vast array of mediators of cell function, like growth factor and cytokines. And last but not least, the minute number of ‘native’ MSC in the bone marrow can be easily increased by ex vivo procedures
A cohort of 10 patients (13 hips) with functional and radiological evidences of hip arthritis (either in one or both hips was included in the study. Autologous bone marrow-derived mesenchymal stem cells were prepared by ex vivo expansion procedures and infused into the damaged articulation (s) of each patient in three consecutive weekly doses of 20 x 106 cells/each. Before and after completion of the cell infusion scheme, all patients were clinically evaluated (hip scores for pain, stiffness, physical function, range of motion and X-ray measurements), to assess whether the cell infusion procedure was innocuous or beneficial. The mean age was 50,3 years with a follow-up of 23 months (range 12-35).
The preop mean scores were 4.1 VAS, 36,5 WOMAC, 61,5 mHHS and 61 VAIL; with a final follow-up mean of: 1, 19,2, 85 , 74 respectively.
No patient show a major complication with the procedura, and no patient requires THA at the end of the follow-up.
This results are encouraging, and suggesting that the ex vivo expanded bone marrow-derived MSC intraarticular infusion, is a safe and promising alternative in treatment of a symptomatic hip OA, with early results that maintained over time.