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Transplantation of Adipose-Derived Mesenchymal Stem Cells for Ankle Articular Cartilage Focal Lesions


Michail I. Iosifidis, MD, PhD
GREECE

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Transplantation of Adipose-Derived Mesenchymal Stem Cells for Ankle Articular Cartilage Focal Lesions

Michail I. Iosifidis, MD, PhD, GREECE Tryfon Totlis, MD, PhD, GREECE Konstantinos Apostolidis, MD, GREECE Theofylaktos Kyriakidis, MD, MSc, PhD, GREECE Efstathios Michalopoulos, PhD, GREECE Theophanis Chatzistamatiou, PhD, GREECE Andreas Papasavas, PhD, GREECE Ioannis Tsitouridis, MD, PhD, GREECE Aikaterini Stavropoulos, MD, PhD, GREECE Anastasios Miltiades Kyriakidis, Senior Consultant, GREECE

2nd Orthopaedic Department, "Papageorgiou" General Hospital, Thessaloniki, Radiology Department, "Papageorgiou" G.H., Thessaloniki, Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens (BRFAA), Thessaloniki, Athens, GREECE

2015 Congress   Paper Abstract   2015 Congress   Not yet rated

 

Anatomic Location

Ankle / Foot / Calf

Anatomic Structure

Cartilage

Diagnosis Method

MRI

Sports Medicine

Outcome Studies

Treatment / Technique

Stem Cell Therapy

Cartilage

Cartilage Treatment Cartilage Injuries

Summary: The use of MSCs for ankle focal cartilage lesions, a safe and promising procedure

Purpose

Aim

of this pilot prospective study was to evaluate the results of transplantation of adipose-derived mesenchymal stem cells for the treatment of focal ankle chondral lesions.

Matelrial and Methods: Six patients (male:female 2:4), mean aged 28.67 (18-42 years), having 6 ICRS grade 3 and 4 focal ankle chondral defects were included. Medial malleolar osteotomy was performed in four patients having a posteromedial talar lesion. One patient with an anteromedial talar lesion and another having a tibial plafond lesion underwent an all-arthroscopic procedure. This single-staged procedure included filling of each defect with autologous culture-expanded mesenchymal stem cells, isolated from abdominal subcutaneous fat and embedded in a trimmed-to-fit commercially available biodegradable matrix. Patients were evaluated using the Foot and Ankle Outcome Score (FAOS) scale at 1st, 3rd, 6th, 12th and 24th p.o. month (mean 17.5 months). The non-parametric Wilcox Signed Ramk test was used to determine significant differences between preoperative and postoperative values (p<0.05). In addition the patients underwent MRI (3 Tesla) at the 12th and 24th p.o. month using the Magnetic Resonance Obsrevation of Cartilage Repair (MOCART) scoring system.

Results

No complications or adverse events were reported. All six patients were found to be satisfied. A significant increase in mean values of all FAOS subscales was found, whereas the total FAOS improved from 32.8 to 78.6, p=0.05. The MOCART score revealed significant development of tissue resembling the healthy cartilage.

Conclusions

Treatment of focal ankle chondral lesions with this single-staged cell-based technique demonstrated promising preliminary results, according to relevant outcome scores. It is need longer follow up period and larger patients number in order to reach safer results for the effectiveness of this treatment option.