18
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A 24-Month Follow-Up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Osteoarthritis (OA) is a widely prevalent disease worldwide, and with an increasingly ageing society, it has become a challenge for the field of regenerative medicine. OA is a disease process involving multiple joint tissues, including those not visible on radiography, and is a complex disease process with multiple phenotypes that require evaluation by a multimodality imaging assessment. The purpose of this study was to evaluate the effect of micro-fragmented fat tissue intra-articular injection 24 months after application in two ways: Indirectly using functional magnetic resonance imaging (MRI) assessment analyzing the glycosaminoglycans (GAG) content in cartilage by means of delayed gadolinium (Gd)-enhanced magnetic resonance imaging of cartilage (dGEMRIC), as well as clinical outcome on observed level of GAG using standard orthopedic physical examination including VAS assessment. In our previous study assessing comprehensive results after 12 months, the dGEMRIC results have drawn attention. The present study explores the long-term effect of intra-articular injection of autologous microfragmented adipose tissue to host chondrocytes and cartilage proteoglycans in patients with knee OA. A prospective, non-randomized, interventional, single-center, open-label clinical trial was conducted from January 2016 to April 2018. A total of 17 patients were enrolled in the study, and 32 knees were assessed in a 12-month follow-up, but only 10 patients of them with 18 knees are included in a 24-month follow-up. The rest of the seven patients dropped out of the study 12 months after follow-up: three patients underwent knee arthroplasty, and the remaining four did not fulfil the basic criteria of 24 months involvement in the study. Surgical intervention (lipoaspiration), followed by tissue processing and intra-articular injection of the final microfragmented adipose tissue product into the affected knee(s), was performed in all patients. Patients were assessed for a visual analog scale (VAS), dGEMRIC at the baseline, three, six, 12 and 24 months after the treatment. A magnetic resonance sequence in dGEMRIC due to infiltration of the anionic, negatively-charged contrast gadopentetate dimeglumine (Gd-DTPA2) into the cartilage indicated that the contents of cartilage glycosaminoglycans significantly increased in specific areas of the treated knee joint. Our results suggest that this method of single intra-articular injection of autologous microfragmented adipose tissue improves GAG content on a significant scale, with over half of the measurements suggesting relevant improvement 24 months after intra-articular injection opposed to the expected GAG decrease over the natural course of the disease.

          Related collections

          Most cited references25

          • Record: found
          • Abstract: found
          • Article: not found

          Infrapatellar fat pad-derived mesenchymal stem cell therapy for knee osteoarthritis.

          The aim of the study was to determine if isolated mesenchymal stem cells (MSCs) derived from the infrapatellar fat pad could effectively improve clinical results when percutaneously injected into arthritic knees. Therapeutic case-control study; Level III. Twenty five stem cell injections combined with arthroscopic debridement were administered to patients with knee OA. A mean of 1.89 × 10(6) stem cells were prepared with approximately 3.0 mL of platelet-rich plasma (PRP) and injected in the selected knees of patients in the study group. The mean Lysholm, Tegner activity scale, and VAS scores of patients in the study group improved significantly by the last follow-up visit. No major adverse events related to the injections were observed during the treatment and follow-up periods. The results were compared between the study and control groups, in which the patients had undergone arthroscopic debridement and PRP injection without stem cells. Although the preoperative mean Lysholm, Tegner activity scale, and VAS scores of the study group were significantly poorer than those of the control group, the clinical results at the last follow-up visit were similar and not significantly different between the two groups. The short-term results of our study are encouraging and demonstrate that infrapatellar fat pad-derived MSC therapy with intraarticular injections is safe, and provides assistance in reducing pain and improving function in patients with knee OA. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Injectable cultured bone marrow-derived mesenchymal stem cells in varus knees with cartilage defects undergoing high tibial osteotomy: a prospective, randomized controlled clinical trial with 2 years' follow-up.

            To analyze the results of the use of intra-articular cultured autologous bone marrow-derived mesenchymal stem cell (MSC) injections in conjunction with microfracture and medial opening-wedge high tibial osteotomy (HTO). Fifty-six knees in 56 patients with unicompartmental osteoarthritic knees and genu varum were randomly allocated to the cell-recipient group (n = 28) or control group (n = 28). Patients who had a joint line congruity angle of more than 2°, malalignment of the knee from femoral causes, a fixed flexion deformity, or age older than 55 years were excluded. All patients underwent HTO and microfracture. The cell-recipient group received intra-articular injection of cultured MSCs with hyaluronic acid 3 weeks after surgery, whereas the control group only received hyaluronic acid. The primary outcome measure was the International Knee Documentation Committee (IKDC) score at intervals of 6 months, 1 year, and 2 years postoperatively. Secondary outcome measures were Tegner and Lysholm clinical scores and 1-year postoperative Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores. The median age of the patients was 51 years, with a mean body mass index of 23.85. Both treatment arms achieved improvements in Tegner, Lysholm, and IKDC scores. After adjustment for age, baseline scores, and time of evaluation, the cell-recipient group showed significantly better scores. The effect of treatment showed an added improvement of 7.65 (95% confidence interval [CI], 3.04 to 12.26; P = .001) for IKDC scores, 7.61 (95% CI, 1.44 to 13.79; P = .016) for Lysholm scores, and 0.64 (95% CI, 0.10 to 1.19; P = .021) for Tegner scores. Magnetic resonance imaging scans performed 1 year after surgical intervention showed significantly better MOCART scores for the cell-recipient group. The age-adjusted mean difference in MOCART score was 19.6 (95% CI, 10.5 to 28.6; P < .001). Intra-articular injection of cultured MSCs is effective in improving both short-term clinical and MOCART outcomes in patients undergoing HTO and microfracture for varus knees with cartilage defects. Level II, randomized controlled trial. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Pain measurement in the elderly: a review.

              C Antona (2001)
              Measurement of pain in the elderly is an issue that has received limited attention. The purpose of this review was to analyze and synthesize research findings from 1975 to 1999 that are related to pain measurement in the elderly. Based on best-evidence synthesis criteria, the review led to the selection of 15 studies. These studies used a descriptive and quantitative analytic approach and were not based on a theoretical framework. Comparison of selected pain measurement tools was incorporated in 40% of the included studies. Substantial gaps in knowledge were identified; namely, these included determining the reliability and validity of selected tools for the institutionalized or community-dwelling elder; modifying instruments to overcome barriers such as communication issues, cultural diversity, or cognitive dysfunction; and expanding the scope of pain measurement to other dimensions of the pain experience.
                Bookmark

                Author and article information

                Journal
                Genes (Basel)
                Genes (Basel)
                genes
                Genes
                MDPI
                2073-4425
                17 December 2019
                December 2019
                : 10
                : 12
                : 1051
                Affiliations
                [1 ]St. Catherine Specialty Hospital, 49210 Zabok/10000 Zagreb, Croatia; damir.hudetz@ 123456svkatarina.hr (D.H.); eduard.rod@ 123456svkatarina.hr (E.R.); zeljko.jelec@ 123456svkatarina.hr (Ž.J.); andrea.skelin@ 123456svkatarina.hr (A.S.);
                [2 ]School of Medicine, University of Split, 21000 Split, Croatia
                [3 ]Medical School, University of Rijeka, 51000 Rijeka, Croatia
                [4 ]School of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
                [5 ]Clinical Hospital “Sveti Duh”, 10000 Zagreb, Croatia; trpimir.vrdoljak@ 123456gmail.com
                [6 ]School of Medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia
                [7 ]Department of Nursing, University North, 48 000 Varaždin, Croatia
                [8 ]Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia; iakmacic@ 123456genos.hr (I.T.-A.); glauc@ 123456genos.hr (G.L.)
                [9 ]Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
                [10 ]Children’s Hospital Srebrnjak, 10000 Zagreb, Croatia
                [11 ]Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA
                [12 ]The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, CT 06516, USA
                [13 ]School of Medicine, Faculty of Dental Medicine and Health, University “Josip Juraj Strossmayer”, 31000 Osijek, Croatia
                Author notes
                [* ]Correspondence: igor.boric@ 123456svkatarina.hr (I.B.); draganprimorac2@ 123456gmail.com (D.P.); Tel.: +385-98-624-266 (I.B.); +385-98-470-710 (D.P.)
                Author information
                https://orcid.org/0000-0003-0607-2462
                https://orcid.org/0000-0002-0475-0197
                https://orcid.org/0000-0001-6569-9287
                https://orcid.org/0000-0003-0106-0155
                Article
                genes-10-01051
                10.3390/genes10121051
                6947241
                31861180
                c146d737-729a-414b-9255-fda0c2a3dacd
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 September 2019
                : 11 December 2019
                Categories
                Article

                mesenchymal stem cell,knee osteoarthritis,adipose tissue,regenerative medicine,dgemric,glycosaminoglycans,cartilage

                Comments

                Comment on this article