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Safety and effectiveness of arthroscopic-assisted implantation of allogenic umbilical cord blood-derived mesenchymal stem cells (Cartistem®)
Arthrosc Orthop Sports Med 2023;10:28-33
Published online May 1, 2023;  https://doi.org/10.14517/aosm23001
© 2023 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Dong Hyuk Cha, Dong Hwi Kim, Jeong Min Kook

Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, Korea
Correspondence to: Dong Hwi Kim, https://orcid.org/0000-0001-7011-8504
Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Korea. Tel: +82-62-220-3147, Fax: +82-62-226-3379, E-mail: oskdh@chosun.ac.kr
Received February 10, 2023; Revised March 12, 2023; Accepted March 14, 2023.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The purpose of this study was to investigate the safety and efficacy of arthroscopy-assisted implantation of Cartistem®, an articular cartilage regeneration treatment composed of allogeneic umbilical cord blood-derived mesenchymal stem cells, during medial owHTO for KL grades II and III patients with medial compartment osteoarthritis of the knee joint; radiological and clinical.
Methods: From October 2017 to July 2019, arthroscopic chondroplasty with Cartistem® and medial owHTO were done on lesions with ICRS grade IV in patients with medial compartment arthritis and varus knee. Radiological outcomes including magnetic resonance imaging before and 1 year after surgery were used to calculate the extent of a chondral defect, KL grade, and joint space distance. Furthermore, the KSS and Lysholm score were calculated before and after surgery. The ICRS grade was determined at least 1 year following the operation through the second arthroscopy.
Results: Eight patients who were followed up on for more than 1 year and had the second arthroscopy were investigated retrospectively out of a total of 22 cases. In radiological comparison before and after surgery, the KL grade was improved from III to II in two patients. In 8 patients, the JSD improved dramatically from 3.75 mm to 4.63 mm. The anatomical femorotibial angle was adjusted from varus 2.46° to valgus 9.28°. In the clinical score of 8 patients, the KSS climbed from an average of 46.63 to 70.50 and the Lysholm score increased from an average of 43.5 to 75.5, showing a substantial difference. Furthermore, all patients who underwent a second arthroscopy had a significant improvement in their ICRS grade.
Conclusion: For individuals with KL grade II and III and ICRS Grade IV medial compartment osteoarthritis of the knee, chondroplasty with Cartistem® under arthroscopy during medial owHTO can significantly improve the radiological and clinical outcomes.
Keywords : High tibial osteotomy; Arthroscopy; Chondroplasty; Cartistem
References
  1. Schuster P, Schulz M, Mayer P, Schlumberger M, Immendoerfer M, Richter J. Open-wedge high tibial osteotomy and combined abrasion/microfracture in severe medial osteoarthritis and varus malalignment: 5-year results and arthroscopic findings after 2 years. Arthroscopy 2015;31:1279-88.
    Pubmed CrossRef
  2. Koh YG, Choi YJ, Kwon OR, Kim YS. Second-look arthroscopic evaluation of cartilage lesions after mesenchymal stem cell implantation in osteoarthritic knees. Am J Sports Med 2014;42:1628-37.
    Pubmed CrossRef
  3. Nejadnik H, Hui JH, Feng Choong EP, Tai BC, Lee EH. Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Am J Sports Med 2010;38:1110-6.
    Pubmed CrossRef
  4. Buda R, Vannini F, Cavallo M, Grigolo B, Cenacchi A, Giannini S. Osteochondral lesions of the knee: a new one-step repair technique with bone-marrow-derived cells. J Bone Joint Surg Am 2010;92 Suppl 2:2-11.
    Pubmed CrossRef
  5. Gobbi A, Karnatzikos G, Sankineani SR. One-step surgery with multipotent stem cells for the treatment of large full-thickness chondral defects of the knee. Am J Sports Med 2014;42:648-57.
    Pubmed CrossRef
  6. Jo CH, Lee YG, Shin WH, et al. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells 2014;32:1254-66.
    Pubmed CrossRef
  7. Kim YS, Choi YJ, Koh YG. Mesenchymal stem cell implantation in knee osteoarthritis: an assessment of the factors influencing clinical outcomes. Am J Sports Med 2015;43:2293-301.
    Pubmed CrossRef
  8. Qi Y, Feng G, Yan W. Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis. Mol Biol Rep 2012;39:5683-
    Pubmed CrossRef
  9. 9. Mobasheri A, Kalamegam G, Musumeci G, Batt ME. Chondrocyte and mesenchymal stem cell-based therapies for cartilage repair in osteoarthritis and related orthopaedic conditions. Maturitas 2014;78:188-98.
    Pubmed CrossRef
  10. Wang M, Yang Y, Yang D, et al. The immunomodulatory activity of human umbilical cord blood-derived mesenchymal stem cells in vitro. Immunology 2009;126:220-32.
    Pubmed KoreaMed CrossRef
  11. Park YB, Ha CW, Lee CH, Park YG. Restoration of a large osteochondral defect of the knee using a composite of umbilical cord blood-derived mesenchymal stem cells and hyaluronic acid hydrogel: a case report with a 5-year follow-up. BMC Musculoskelet Disord 2017;18:59.
    Pubmed KoreaMed CrossRef
  12. Gao J, Dennis JE, Solchaga LA, Awadallah AS, Goldberg VM, Caplan AI. Tissue-engineered fabrication of an osteochondral composite graft using rat bone marrow-derived mesenchymal stem cells. Tissue Eng 2001;7:363-71.
    Pubmed CrossRef
  13. Saris DB, Vanlauwe J, Victor J, et al. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med 2008;36:235-46.
    Pubmed CrossRef
  14. Seo SS, Kim CW, Jung DW. Management of focal chondral lesion in the knee joint. Knee Surg Relat Res 2011;23:185-96.
    Pubmed KoreaMed CrossRef
  15. Krill M, Early N, Everhart JS, Flanigan DC. Autologous chondrocyte implantation (ACI) for knee cartilage defects: a review of indications, technique, and outcomes. JBJS Rev 2018;6:e5.
    Pubmed CrossRef
  16. Ham O, Lee CY, Kim R, et al. Therapeutic potential of differentiated mesenchymal stem cells for treatment of osteoarthritis. Int J Mol Sci 2015;16:14961-78.
    Pubmed KoreaMed CrossRef
  17. Ha CW, Park YB, Chung JY, Park YG. Cartilage repair using composites of human umbilical cord blood-derived mesenchymal stem cells and hyaluronic acid hydrogel in a minipig model. Stem Cells Transl Med 2015;4:1044-51.
    Pubmed KoreaMed CrossRef

May 2024, 11 (1)
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