High tibial osteotomy with human umbilical cord blood-derived mesenchymal stem cells implantation for knee cartilage regeneration

Song, Jun-Seob; Hong, Ki-Taek; Kong, Chae-Gwan; Kim, Namin; Jung, Jae-Yub; Park, Han-Soo; Kim, Young Ju; Chang, Ki Bong; Kim, Seok Jung

doi:10.4252/wjsc.v12.i6.514

Cited by 34 publications

(50 citation statements)

References 54 publications

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“…Previous case series about HTO with hUCB-MSCs reported good clinical outcomes and cartilage regeneration. 15,19,20 The current study agreed with these results, with good clinical outcomes and JSW increments in elderly patients.…”

Section: Discussionsupporting

confidence: 88%

“…After saline drainage, off-the-shelf hUCB-MSC product, Cartistem (MEDIPOST, Seongnam, South Korea), was applied. This product consists of 1.5 mL hUCB-MSCs (7.5 × 10 6 cells/vial) and 4% hyaluronic acid hydrogel, and it was approved by the Korea Food and Drug Administration in 2012 and is used for cartilage regeneration 15,19,20,25 (Fig. 1).…”

Section: Surgical Procedures and Postoperative Rehabilitation Protocolmentioning

confidence: 99%

“…13,14 Since the development of cell therapy, various groups have used mesenchymal stem cells (MSCs) for cartilage regeneration, including autologous bone marrow aspirate concentrate (BMAC), autologous fat-derived stromal vascular fraction, autologous stem cells from fat or synovial tissue, and human umbilical cord-blood derived mesenchymal stem cells (hUCB-MSCs). [15][16][17][18][19][20] Previous studies have shown good results for cartilage regeneration using MSCs in HTO patients. [16][17][18] However, there is still concern about using autologous MSCs for cartilage regeneration in elderly patients.…”

Section: Introductionmentioning

confidence: 99%

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Human Umbilical Cord-Blood Derived Mesenchymal Stem Cell Can Improve the Clinical Outcome and Joint Space Width after High Tibial Osteotomy

Suh¹,

Han

Yeo³

et al. 2021

Preprint

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Purpose We compared the clinical and radiologic results of human umbilical cord-blood derived mesenchymal stem cells (hUCB-MSCs)cartilage regeneration procedures combined with HTO to those of microfracture with HTO. Methods From August 2017 to December 2018, HTO patients with International Cartilage Regeneration and Joint Preservation Society (ICRS) grade IV cartilage defects over 200 mm2 on medial femoral condyle (MFC) were enrolled. For comparison, all participants were divided into two groups: those who had undergone an hUCB-MSC induced cartilage regeneration procedure (group MSC) and those with microfractures only (group C, controls). Clinically, Hospital for Special Surgery (HSS), International Knee Documentation Committee (IKDC), and Lysholm scores were evaluated post-operatively at 18 months. Radiologically, mechanical axis (MA) and joint space width (JSW) were evaluated. Results A total of 100 knees were enrolled (43 in group MSC, 57 in group C). The IKDC score in group MSC (69) was better than that in group C (62; P < 0.05). The JSW increment in the MSC group (0.6 mm) was more than that in group C (0.1 mm; P < 0.05). No patient developed nonunion, correction loss, or arthroplasty conversion. Conclusion hUCB-MSCs can improve clinical outcome and JSW better than microfracture only in HTO patients.

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Section: Discussionsupporting

confidence: 88%

Section: Surgical Procedures and Postoperative Rehabilitation Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Human Umbilical Cord-Blood Derived Mesenchymal Stem Cell Can Improve the Clinical Outcome and Joint Space Width after High Tibial Osteotomy

Suh¹,

Han

Yeo³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Various augmentation methods, such as collagen substitutes, osteochondral grafts, and autologous chondrocyte implantation have been suggested, but the use of these is limited to elderly patients with OA [13,14]. Since the development of cell therapy, various groups have used mesenchymal stem cells (MSCs) for cartilage regeneration, including autologous bone marrow aspirate concentrate (BMAC), autologous fat-derived stromal vascular fraction, autologous stem cells from fat or synovial tissue, and human umbilical cord-blood derived mesenchymal stem cells (hUCB-MSCs) [15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Human umbilical cord-blood-derived mesenchymal stem cell can improve the clinical outcome and Joint space width after high tibial osteotomy

Suh¹,

Han²,

Yeo³

et al. 2021

The Knee

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Background: There is limited study about the human umbilical cord-blood derived mesenchymal stem cell (hUCB-MSC) cartilage regeneration procedures combined with high tibial osteotomy (HTO). We compared the clinical and radiological results of hUCB-MSC cartilage regeneration procedures combined with HTO to those of microfracture with HTO. Methods: From August 2017 to December 2018, HTO patients with International Cartilage Regeneration and Joint Preservation Society (ICRS) grade IV cartilage defects over 200 mm 2 on medial femoral condyle (MFC) were enrolled. For comparison, all participants were divided into two groups: those who had undergone an hUCB-MSC induced cartilage regeneration procedure (group MSC) and those with microfractures only (group C, controls). Clinically, Hospital for Special Surgery (HSS), International Knee Documentation Committee (IKDC), and Lysholm scores were evaluated post-operatively at 18 months. Radiologically, mechanical axis (MA) and joint space width (JSW) were evaluated. Results: A total of 100 knees were enrolled (43 in group MSC, 57 in group C). The IKDC score in group MSC (69) was better than that in group C (62; P < 0.05). The JSW increment in the MSC group (0.6 mm) was more than that in group C (0.1 mm; P < 0.05). No patient developed nonunion, correction loss, or arthroplasty conversion. Conclusion: hUCB-MSCs can improve clinical outcome and JSW better than microfracture only in HTO patients.

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“…Although the choice of indications is still controversial, the vast majority of scholars believe that HTO has a good effect in younger patients who are limited to medial compartment osteoarthritis, do not involve bone-to-bone wear, combine with mild and moderate varus deformity originating from the tibial side, and have a greater demand for mobility [ 20 , 21 ]. Most scholars believe that [ 14 , 22 – 24 ] the weight-bearing line should be corrected to slightly valgus, so as to effectively reduce the medial compartment stress and avoid the recurrence of varus deformity, but excessive valgus will increase the lateral compartment stress, which has the risk of causing lateral compartment osteoarthritis. According to different literature reports [ 1 , 7 ], good long-term efficacy can be achieved when correction is made to valgus at 3-13°.…”

Section: Discussionmentioning

confidence: 99%

Preoperative planning by osteotomy master software helps to improve the accuracy of target limb alignment in high tibial osteotomy

Mao

Zhou

et al. 2020

J Orthop Surg Res

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Background The accuracy of targeted lower limb alignment correction following HTO is closely related to patients’ pain relief and knee joint survival time. How to accurately perform osteotomy and how to obtain the ideal target limb alignment to maximize the curative effect are the difficulty in HTO practice. The purpose of this study is to evaluate the predictive and application value of osteotomy master software (OsteoMaster) in coronal plane preoperative planning of high tibial osteotomy. Method Sixty-seven patients with medial compartment osteoarthritis and varus deformity treated by medial open-weight high tibial osteotomy were enrolled and divided into observation group (31 cases) and control group (36 cases). The observation group was planned by OsteoMaster, while the control group was planned by Miniaci. The preoperative predicted values of osteotomy depth, open height, correction angle, WBL ratio, and FTA of the observation group were compared with the actual intraoperative values to study their accuracy. The operative time, blood loss, number of fluoroscopy, and WBL ratio were compared between the observation group and the control group to study its application value. Result There was no significant difference between two groups in preoperative prediction and intraoperative reality of osteotomy depth, open height, correction angle, FTA, and WBL ratio (P > 0.05). The operation time and number of fluoroscopy in the observation group were significantly less than those in the control group (P < 0.05), while the difference in blood loss was not statistically significant (P > 0.05). The good rate of WBL ratio was 87.1% in the observation group and 75% in the control group. Conclusion OsteoMaster has predictive value in osteotomy depth, open height, correction angle, FTA, and WBL ratio of HTO, which is also helpful to reduce the number of fluoroscopy, shorten the operation time, and improve the accuracy of target limb alignment. The drawback of this approach is 2-dimensional approach in contrast to 3-dimensional preoperative planning that is including the more real study.

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High tibial osteotomy with human umbilical cord blood-derived mesenchymal stem cells implantation for knee cartilage regeneration

Cited by 34 publications

References 54 publications

Human Umbilical Cord-Blood Derived Mesenchymal Stem Cell Can Improve the Clinical Outcome and Joint Space Width after High Tibial Osteotomy

Human Umbilical Cord-Blood Derived Mesenchymal Stem Cell Can Improve the Clinical Outcome and Joint Space Width after High Tibial Osteotomy

Human umbilical cord-blood-derived mesenchymal stem cell can improve the clinical outcome and Joint space width after high tibial osteotomy

Preoperative planning by osteotomy master software helps to improve the accuracy of target limb alignment in high tibial osteotomy

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