Unstable effect of single intra-articular injection of adipose-derived mesenchymal stem cells immersed in hyaluronan gel on knee steoarthritis

IntroductionMesenchymal stem cells (MSCs) as multi-potential stem cells are capable of differentiating into various cell types including osteoblasts, chondrocytes, myocytes and adipocytes. Considering the chondrogenic potential of MSCs, scientists have tried to repair cartilage defects in osteoarthritic joints using different modalities.ObjectivesIn this study we sought to investigate the effect of intra-articular injection of adipose-derived MSCs immersed in hyaluronan gel (hyaluronic acid containing gel) on clinical improvement of patients with knee osteoarthritis (OA).MethodsSix patients with grade 2 and 3 knee OA were included. After signing informed consent, the patients underwent lipo-surgery under local anesthesia and the resected fat cubes were sent to the laboratory for MSC isolation and expansion. All patients received single injection of a preparation consisting of 2-3 × 106 AD-MSCs, 2 mL hyaluronan gel and 0.2 mL dexamethasone. The patients were evaluated prior to injection (baseline) as well as in 2 follow-up visits (6 and 12 months post-injection) according to numerical rating scale (NRS) for subjective measurement of pain.ResultsSix patients (100% female) with mean age of 58.8 ± 7.1 years were studied. By the effect of the treatment, the median of the pain score (based on NRS) decreased significantly (P < 0.05) from 6 (5-9) in the baseline visit to 4 (2-8) in the second visit (6th month post-injection). However, in the 12th month post-injection (2nd follow-up visit) the median of pain score slightly rose to 5 (3-8), though the difference between the visits was not significant.ConclusionsSingle intra-articular injection of autologous AD-MSCs immersed in hyaluronan gel although was effective in reducing pain in patients with knee OA during the first 6 months, its effect is perhaps not long-lasting, and therefore repetition of injection is needed

کلیدواژه ها:

Adipose tissue ، Intra-articular Injection ، Knee osteoarthritis ، Mesenchymal stem cells ، Pain score