Stem Cell Research

Abstract

Patellofemoral Osteoarthritis: Treatment with Autologous Bone Marrow Mononuclear Cells and Arthroscopic Surgery, a Prospective Study

Marcus Valladares Guimarães, Paula Alexandra da Graça Morais Rios, Milton Artur Ruiz, José Carlos Pinto Noronha, Dalton Lopes Terra, Jose Fabio Santos Duarte Lana.

Objective: The aim of this study was to evaluate the treatment using BMMCs and arthroscopy in PF OA through functional questionnaires and MRI evaluations in a two year follow up. The use of mononuclear cells derived from bone marrow (BMMCs) is under investigation, and in vitro and pre-clinic studies showed promisor results. In comparison to the mesenchymal stem cells (MSC), the effectiveness is lower, however the costs for manipulation and laboratory handling make it difficult to use in clinical practice.

Design: This was a pilot, longitudinal and prospective trial and 8 patients with patellofemoral osteoarthritis who met the study criteria were included. All of the patients underwent arthroscopic debridement and received an injection of autologous BMMCs. Clinical outcomes were evaluated using SF-36 and the TLKSS questionnaire at baseline, one and two years after the procedure.

Results: In this study, an improvement in all of the evaluated parameters of the questionnaire was verified even after two years following the applications. The functional score of TKLSS showed a significant improvement in one and two years in comparison to the baseline (p<0.001). A significant improvement in SF-36 for all of the domains (p<0.001) was also verified. In addition, an improvement in the MRI images of the patients was noticed, which indicates patellar cartilage recovery.

Conclusion: The procedure of the arthroscopy and the application of BMMCs has proved promising results to reduce the signs of PF OA and ensure the patient satisfaction with a safe return to social life and sports practice. The completed questionnaire confirmed a clear improvement and a strong impact on the quality of life of the patients with the regeneration of their articular cartilage and restored subchondral bone. These results offer a wide perspective for future studies with the use of BMMC to treat articular diseases.