Mesenchymal stem cells (MSCs) are known to have a potential for articular cartilage regeneration. However, most studies focused on focal cartilage defect through surgical implantation. For the treatment of generalized cartilage loss in osteoarthritis, an alternative delivery strategy would be more appropriate. The purpose of this study was to assess the safety and efficacy of intra-articular injection of autologous adipose tissue derived MSCs (AD-MSCs) for knee osteoarthritis. We enrolled 18 patients with osteoarthritis of the knee and injected AD MSCs into the knee. The phase I study consists of three dose-escalation cohorts; the low-dose (1.0 3 10 7 cells), mid-dose (5.0 3 10 7 ), and high-dose (1.0 3 10 8 ) group with three patients each. The phase II included nine patients receiving the high-dose. The primary outcomes were the safety and the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at 6 months. Secondary outcomes included clinical, radiological, arthroscopic, and histological evaluations. There was no treatment-related adverse event. The WOMAC score improved at 6 months after injection in the high-dose group. The size of cartilage defect decreased while the volume of cartilage increased in the medial femoral and tibial condyles of the high-dose group. Arthroscopy showed that the size of cartilage defect decreased in the medial femoral and medial tibial condyles of the high-dose group. Histology demonstrated thick, hyaline-like cartilage regeneration. These results showed that intra-articular injection of 1.0 3 10 8 AD MSCs into the osteoarthritic knee improved function and pain of the knee joint without causing adverse events, and reduced cartilage defects by regeneration of hyaline-like articular cartilage.

NCT01300598.

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This HIPAA-compliant study was exempt from institutional review board approval because the 10 image data sets were deidentified in the Osteoarthritis Initiative database, and they were processed and analyzed without any clinical information being accessed. The purpose of this study was to prospectively evaluate the efficiency and reproducibility of the semiautomated graph-cut method (SA method) in the segmentation of knee cartilage and to compare its performance with that of the conventional manual delineation segmentation method (M method). Two radiologists independently performed segmentation with each method in two separate sessions: They performed the M method (M1 and M2 for the first and second sessions, respectively) for every third section and the SA method (SA1 and SA2 for the first and second sessions, respectively) for every section. The SA method was significantly more efficient (mean processing time, 53 minutes vs 156 minutes for SA1 vs M1 and 53 minutes vs 118 minutes for SA2 vs M2; P < .001) and reproducible (mean volume overlap, 94.3% vs 87.8% for the SA method vs the M method; P < .001) than the M method.

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