Category: Clinical Sciences/Health Conditions
Objectives: The capacity of articular cartilage is limited to heal due to low mitotic potential of chondrocyte in vivo. Thus defect in the Joint cartilage progress to osteoarthritis (OA). To address this limitation, the use of autologous Bone Marrow Aspirate Concentrate Mesenchymal Stem cells (BMAC-MSCs) was investigated. The objective of this study was to find out the clinical outcome of cartilage regeneration in knee OA stage III (Kellgren Lawrence) by stem cell.
Design: It is a prospective experimental study. We recruited six patients of stage-III OA knee for cartilage regeneration treated by BMAC-MSCs from 1st Jan to 31st July, 2019. Each patient took BMAC-MSCs for one time. With all aseptic precautions, Ultrasound (US) guided aspiration of total 100cc BMAC from right & left posterior-superior iliac spine (PSIS).Then BMAC-MSCs was processed and got about 10cc MSCs which was injected by US guided into knee joint. Then 5cc BMAC-MSCs injection was given into each knee joint followed by planned rehabilitation program at 2 weeks and follow up was taken at 2 weeks,1 month, 2 months & 6 months.
Results: After 2 months, all patients were is pain free (VAS-0) with full ROM. The improvement of mean ROM is in right knee 71.67±16.02, 121.67±11.69, 128.33±4.08, 130.00±0.00 and in left knee 75.0±15.2, 120.0±8.9, 130.0±0.0, 130.0±0.0 at 2 weeks,1month,2months & 6 months respectively(p< .001).Mean Oxford Knee Score (OKS) was 33.0±0.0, 43.0±3.1, 47.0±0.0 and 47.0±0.0 at same intervals respectively (p< .001). After 2 months, there is significant improvement of right & left medial tibiofemoral distance in x-ray 0.39±0.17 & 0.42±0.18cm (Mean±SD) & in US, right & left cartilage thickness 0.36±0.35 and 0.16±0.04cm (Mean±SD) respectively.
Conclusions: Approach of BMAC-MSCs into Knee OA stage-III can reduce disability and prevent knee replacement surgery in the long run. A large scale research is need to establish the effectiveness of stem cell induced cartilage regeneration.
mohammad moniruzzaman– Associate Professsor, Dhaka Medical College