2017 ISAKOS Biennial Congress ePoster #235

 

Optimized Scaffold Seeded With Autologous Bm-Msc Differentiated To Chondrocytes In Patients Suffering Knee Osteochondral Lesions

Rodrigo M. Mardones, MD, Santiago CHILE
Alessio Giai Via, MD, Santiago CHILE
Claudio Jofre, PhD, Santiago CHILE
Daniel R. Camacho, MD, Santiago, RM CHILE
Edgar Narvaez, PhD, Santiago, RM CHILE
Mauricio Wainer, MD, 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:

Summary

In patients with chondral focal lesions, the scaffold containing autologous chondrocytes, coadjuvated with 20 x 106 undifferentiated BM-MSC appears as a feasible, safe and effective procedure for reducing pain and improve function of the knee joint

Abstract

Objetive: The study was developed to translate to the clinic the notion that autologous bone marrow-derived mesenchymal stem cells (BM-MSC) differentiated to chondrocytes in an optimized collagen scaffold can alleviate via secretion of extracellular matrix and different molecular signals that could contribute to lessening and/or cure the function of the damaged knee joint.
A cohort of 15 patients with functional and radiologic evidences of chondral lesions in hyaline cartilage of knee joint was included in the study. Autologous bone marrow-derived mesenchymal stem cells were prepared by ex vivo expansion procedures and then seeded into collagen matrix scaffold at 200.000 cells/cm2 each day for 3 days. The scaffold was left 2 more days, to increase the amount of cells attached and finally differentiated with a mix containing TGF-ß1, ascorbic acid and ITS for 15 days. Histological analyses (Toluidine blue, Hematoxiline-eosin) were made to demonstrate the quality of the scaffold. The scaffold containing autologous chondrocytes was coadjuvated with 20 x 106 BM-MSC into the damaged articulation of each patient.
The scaffold containing autologous chondrocytes was placed in an open surgery. Before and after completion the surgery, all patients were clinically evaluated (EVA Score, knee scores: Oxford and Lysholm , and T2 mapping Magnetic Resonance) to asses whether the procedure was innocuous or beneficial in cartilage repair.
An improvement in all scores was noticed in all patients, 8 patients were considered with excellent improvement (60%), 3 patients with good improvement (20%), 2 patients were regular (14%) and 1 patient was poor responder (6%).