ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Human Umbilical Cord-Derived Mesenchymal Stem Cells Associated to Collagen Matrix for Knee Chondral Lesions Repair: Initial Clinical Experience

Fabiano Kupczik, MD, PhD, MSc, Curitiba, Parana BRAZIL
Carmen Lucia Kuniyoshi Rebelatto, PhD, Curitiba, Parana BRAZIL
Alexandra Cristina Senegaglia, PhD, Curitiba, Paraná BRAZIL
Debora Regina Daga, MSc, Curitiba-PR BRAZIL
Daniela Boscaro Marsaro, MSc, Curitiba-PR BRAZIL
Bruna Schaidt, MSc, Curitiba, Paraná BRAZIL
Isadora May Vaz, MSc, Curitiba, Paraná BRAZIL
Lidiane Maria Boldrini Leite, MSc, Curitiba, Paraná BRAZIL
Marlus Eduardo Gunia Schiavon, Curitiba, Parana BRAZIL
Bruno Sbrissia, MD, Curitiba, Parana BRAZIL
Paulo Roberto Slud Brofman, PhD, Curitiba, Parana BRAZIL

Core for Cell Technology, School of Medicine, Pontifícia Universidade Católica do Paraná and Cajuru University Hospital - PUCPR , Curitiba, Paraná, BRAZIL

FDA Status Not Applicable

Summary

Prospective clinical study using human umbilical cord-derived mesenchymal stem cells associated to collagen matrix for knee chondral lesion repair in 7 patients. At 12 months,KOOS (P=.022), KOOS-QoL (P=.034) and VAS (P=.046) scores were significantly improved. All MRI showed signs of full-filling and smooth surface. This safe one-step procedure shows good functional and MRI results in a short-term

ePosters will be available shortly before Congress

Abstract

BACKGROUD: While the treatment of knee chondral lesions remains a challenge, mesenchymal stem cells use has spreading around the world. The allogenic human umbilical cord-derived mesenchymal stem cells (HUC-MSC) have some advantages: ease to obtaining, no ethic issue, no immune response, great plasticity, ease to expanding and cryopreserving in large amount, and ready availability for one-step surgery. Collagen matrix allows adhesion, proliferation and differentiation of these cells and associates are a promising technology for knee chondral lesions repair.

Purpose

To evaluate short-term outcomes of using HUC-MSC associated to a collagen matrix for knee focal chondral lesions repair.

Methods

In a prospective clinical study, seven patients (3 males and 4 females; mean age of 39,8 years) with knee full-thickness chondral lesion were evaluated. The mean size of focal defects was 5,1 cm2 and they were located in medial condyle (2), patella (3) and trochlea (2). All the HUC-MSC were obtained from donors with negative serology to infections. After in vitro expansion, the HUC-MSC had 97% viability; showed negative culture bacterial and/or fungi growth, absence of mycoplasma and endotoxins; flow cytometry analysis showed positive to CD90, CD105, CD29 and CD73 and negative to CD45, CD34, CD14, CD19 and HLA-DR and normal karyotype by GTG cytogenetic analysis. By knee arthrotomy, the collagen matrix Chondro-Gide? was implanted on the chondral defect with sutures and fibrin glue plus the injection of 40 x 106 of HUC-MSC under it. KOOS, VAS and MRI results were compared pre and postoperatively. Statistical significance was set at P< .05.

Results

After 12 months of follow-up, KOOS (P=.022), KOOS-QoL (P=.034), KOOS-ADL (P=.032), KOOS-pain (P=.035), KOOS-symptoms (P=.032), KOOS-Sport/Recreation (P=.022) and VAS (P=.046) scores were significantly improved postoperatively as compared to a baseline. All MRI showed signs of full-filling and smooth surface, and all repairs had complete integration to adjacent cartilage, except one. No adverse effects, rejection or complications were noted.

Conclusion

Human umbilical cord-derived mesenchymal stem cells associated to a collagen matrix is a safe one-step procedure for knee full-thickness chondral lesions repair, with good functional and MRI outcomes in a short-term.

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