Summary: Culture-expanded adipose derived mesenchymal stem cells (AD-MSCs) implantation offers a reliable and stable over time solution for cartilage lesions

Purpose. The present study aims to evaluate the long-term results of a single-stage cell-based procedure for symptomatic focal cartilage defects in the knee and to compare them with that of the mid-term evaluation. It was hypothesized that the good outcomes of culture-expanded adipose derived mesenchymal stem cells (AD-MSCs) implantation reported in previous series would not deteriorate with time.

Methods. Thirty consecutive patients underwent cartilage repair in the knee with adipose-derived culture-expanded mesenchymal stem cells were prospectively followed for 6 years. To assess functional outcomes patients-reported tools were used including two validated subjective knee questionnaires, the Injury & Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) score, the Tegner activity scale and the visual analogue scale (VAS) for pain. Clinical evaluation was quantified by the IKDC examination form. Radiological evaluation of the repair tissue was performed using the MOCART score.

Results. All scores recorded a statistically significant improvement (p <0.05) at the final follow-up compared with baseline. The KOOS evaluation showed increased scores in all subcategories. More precisely, KOOS-pain was improved from 62.6 (range 44.0-70.1) to 95.5 (range 92.0-100.0), KOOS-Symptoms from 60.9 (range 46.3-68.0) to96.0 (range 89.0-96.0), KOOS-ADL 60.0 (range 46.8-74.6) to 92.0 (range 87.8-97.0) KOOS-Sports/Rec from 32.5 (range 20.0-45.0) to 70.0 (range 55.0-85.0) and KOOS-QOL from 34.4 (range 23.5-51.5) to 84.5 (range 73.5-88.0). The average IKDC score increased from to 40.2 (range 33.9-49.7) to 76.6 (range 68.4-84.7). Sport activity evaluated using Tegner Activity Score as well as VAS for pain demonstrated the same tendency of significant improvement. MRI findings confirmed complete filling of the defect and integration to the border zone for 68% of the patients. Three patients underwent postoperative biopsies and the histological analysis demonstrated the presence of hyaline-like tissue.

Conclusions. Adipose-Derived culture-expanded mesenchymal stem cells were shown to be an efficient and safe single-stage cell-based procedure for symptomatic, full-thickness knee chondral lesions. The findings of the present study demonstrate that all patients presented significant long-term clinical, functional and radiological improvement.

Keywords: chondral lesion, adipose derived stem cells, cartilage repair, regenerative medicine, tissue engineering, scaffolds, cell culture expansion

Implications of Surgical Delay in Meniscal Tears Associated with Anterior Cruciate Ligament Injury. ePoster Presentation Fernando Chico-Carpizo, MD, MEXICO Felipe Martinez, MD, MEXICO Guillermo Bobadilla, MD, MEXICO Ricardo Daniel Fernández-Pérez , MD, MEXICO Diego López García, MD, MEXICO Angel de Jesus Balam-May, PhD, MEXICO Felipe E. Cámara, MD, MEXICO
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Comparative Analysis Of Results Of Arthroscopic Acl Reconstruction Between Free Hamstring Graft And Preserved Insertion Hamstring Graft. A Short Term Follow-Up Study ePoster Presentation Rajiv Gupta, PhD , INDIA
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Mind the anterior root of the lateral meniscus. A biomechancial perspective. ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN María Prado-Novoa, MEng, PhD, SPAIN Ana Pérez-Blanca, PhD, SPAIN Belén Estebánez, MEng, SPAIN Álvaro Raya-Herrero, MEng, SPAIN María Josea Espejo-Reina, MD, SPAIN Alejandro Espejo-Baena, MD, SPAIN
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Early Postoperative Results of the First Latin-American Experience with Robotic-Arm-Assisted TKA versus Conventional Technique Abstract Presentation 5 minutes David H. Figueroa, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Tomas Prado, MD, CHILE Juan Jose Sotomayor, MD, CHILE Alberto Alarcon, MD, CHILE Alex Vaisman, MD, Prof., CHILE Rafael Calvo, MD, CHILE
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Biomechanical Comparison of The Fixation Configurations of Soft-Tissue Quadriceps Tendon Graft Using A Suspensory Button ePoster Presentation Kohei Kamada, MD, PhD, UNITED STATES Kanto Nagai, MD, PhD, JAPAN Kouki Nagamune, PhD, JAPAN Yuichi Hoshino, MD, PhD, JAPAN Yuta Nakanishi, MD, PhD, JAPAN Daisuke Araki, MD, PhD, JAPAN Noriyuki Kanzaki, MD, PhD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
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Gonyautoxins 2/3 Local Periarticular Injection For Pain Management After Total Knee Arthroplasty: A Double-Blind, Randomized Study ePoster Presentation Jaime Hinzpeter, MD, CHILE Maximiliano Andres Barahona, MD, MSc, CHILE Julian Aliste, MD, CHILE Cristian Barrientos, MD, CHILE Alvaro Igor Zamorano Cadenas, MD, CHILE Miguel J. L. Palet, MD, CHILE Jaime Alejandro Catalán, MD, CHILE Miguel Del Campo, PhD, CHILE Nestor Lagos, PhD, CHILE
Comparison Of Bone Marrow Aspirate Concentrate And Allogenic Human Umbilical Cord Blood Derived Mesenchymal Stem Cell Implantation On Chondral Defect Of Knee: Assessment Of Clinical And Magnetic Resonance Imaging Outcomes At 2-Year Follow-Up ePoster Presentation Dong Jin Ryu, MD, PhD., KOREA, REPUBLIC OF Myung Ku Kim, MD, KOREA, REPUBLIC OF Yoon Sang Jeon, MD, KOREA, REPUBLIC OF Won Hwan Kwon, MD, KOREA, REPUBLIC OF Yun Moon Jeon, MD, KOREA, REPUBLIC OF Kyeuback Kwon, MD, KOREA, REPUBLIC OF
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Lower Extremity Injury Surveillance of Collegiate Student-Athletes: Epidemiological Insights from the Pac-12 Health Analytics Program ePoster Presentation Lexie K. Ross, BA, UNITED STATES Mary Catherine-Yousif Hamati, MD, UNITED STATES Michael Tuffiash, MS, UNITED STATES Kevin Robell, ATC, UNITED STATES Kenneth J. Hunt, MD, UNITED STATES
Targeting Rule Implementation Decreases Neck Injuries In High School Football: A National Injury Surveillance Study ePoster Presentation Kyle Kosei Obana, BA, UNITED STATES John D Mueller, MD, UNITED STATES Bryan M. Saltzman, BA, UNITED STATES T. Sean Lynch, MD, UNITED STATES Robert L Parisien, MD, UNITED STATES Christopher S. Ahmad, MD, UNITED STATES David P Trofa, MD, UNITED STATES
Pre-Operative Indicators of ACL Reconstruction Outcomes ePoster Presentation Martin Weaver, BS, UNITED STATES Vincent Bruno, BS, UNITED STATES Sean Nemeh, BS, UNITED STATES Muhammad Padela, MD, MSc, UNITED STATES Nicholas Bolz, MD, UNITED STATES Richard Chen, PhD, MD, UNITED STATES Henry Thomas Goitz, MD, UNITED STATES
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Correlation Of The Squat-And-Smile Test Against Other Patient Reported Outcome Scores In Knee Pathology ePoster Presentation Johan Le Roux, FC Ortho, MMed, DA (SA), MB,ChB, SOUTH AFRICA Roopam Dey, PhD, SOUTH AFRICA Simone Deichl, MD, SOUTH AFRICA Maritz Laubscher, MD, SOUTH AFRICA Michael Held, MD, PhD, SOUTH AFRICA
Arthroscopic-Assisted Robotic Bi-Unicompartmental Knee Arthroplasty: A Pilot Cadaveric Study. ePoster Presentation Andrea Fernandez, MD, FRANCE Elliot Sappey-Marinier, MD, FRANCE Frédéric Lavoie, MD, MSc, FRCSC, CANADA Cécile Batailler, MD, PhD, FRANCE Elvire Servien, MD, PhD, Prof., FRANCE Sebastien Lustig, MD, PhD, Prof., FRANCE
Proximal Tibial Varus Osteotomy For Valgus Knee. ePoster Presentation Vitor Barion Castro De Padua, PhD, BRAZIL Marcelo Rodrigues Torres, MD, BRAZIL Halley Paranhos Paranhos, Jr., MD, BRAZIL Lucas Fenandes Piazzalunga, MD, BRAZIL
Posterior Placement Of The Tibial Tunnel Is A Risk Factor For Tibial Tunnel Coalition After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction ePoster Presentation Koji Nukuto, MD, PhD, UNITED STATES Yuichi Hoshino, MD, PhD, JAPAN Shu Watanabe, MD, JAPAN Akiyoshi Mori, JAPAN Yuta Nakanishi, MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Daisuke Araki, MD, PhD, JAPAN Noriyuki Kanzaki, MD, PhD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
Biomechanical Comparison Of Knotted And Knotless Reconstruction Of Full-Thickness Tears Of The Upper Subscapularis Tendon ePoster Presentation Mirco Sgroi, MD, GERMANY Thomas Kappe, MD, Prof., GERMANY Heiko Reichel, Prof., GERMANY Marius Ludwig, MD, GERMANY Michael Fuchs, Dr., GERMANY Anita Ignatius, Prof. Dr., GERMANY Lutz Dürselen, Prof. Dr., GERMANY Andreas M. Seitz, PhD, GERMANY
Analysis of poor clinical outcome after opening-wedge high tibial osteotomy over 65 years old ePoster Presentation Shuhei Otsuki, MD, JAPAN HItoshi Wakama, MD, JAPAN Yoshinori Okamoto, MD, PhD, JAPAN Masashi Neo, MD, PhD, Prof., JAPAN
Anteromedial Rotatory Knee Instability – Much More Than The Medial Collateral Ligament ePoster Presentation Elmar Herbst, MD, PhD, GERMANY Christian Peez, MD, GERMANY R M, Mr., GERMANY Jens Wermers, MD, GERMANY Johannes Glasbrenner, MD, GERMANY Thorben Briese, MD, GERMANY J. Christoph Katthagen, MD, GERMANY Michael J. Raschke, MD, Prof., GERMANY Christoph Kittl, MD, MD(res), GERMANY
Clinical Evaluation Of a Resurfacing Device Biopoly™ Implant For Femoral Osteochondral Defect Greater Than 1 Cm2 At Minimal 2 Years Follow-Up. A Prospective Cohort Study. ePoster Presentation François-Paul Ehkirch, MD, FRANCE Elliott Kierszbaumb, MD, FRANCE Pierre-Alban Bouché, MD, FRANCE
Outcomes After Axial Alignment Correction For Patellofemoral Instability ePoster Presentation Kristen I Barton, MD, PhD, CANADA Nicholas Steiner, BSc, CANADA Kevin R Boldt, PhD, CANADA Olawale A Sogbein, MD, MSc, CANADA Gilbert Moatshe, MD, PhD, NORWAY Elizabeth A. Arendt, MD, UNITED STATES Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
10 Years Results Of Biological ACL Repair For Partial Tears ePoster Presentation Alberto Gobbi, MD, FRACS, ITALY Macarena Morales, MD, ITALY Gabriel Azzini, MD, ITALY Ignacio Dallo, MD, SPAIN
Arthroscopic Repair Of Meniscal Injuries In Patients Over 40 Years Of Age. Results With A Minimum Follow-Up Of 2 Years ePoster Presentation Horacio F. Rivarola-Etcheto, MD, ARGENTINA Cristian Collazo Blanchod, MD, ARGENTINA Marcos Meninato, MD, ARGENTINA Facundo Cosini, MD, ARGENTINA Juan Martín Carraro, MD, ARGENTINA Bruno Terrarossa, MD, ARGENTINA Carlos Mendoza Puello, MD, ARGENTINA
The Gastrocnemius Flap In The Salvage Revision Knee Arthroplasty ePoster Presentation Robert Mcculloch, MBChB MSc FRCS (Tr&Orth), UNITED KINGDOM Amirul Adlan, MBChB, UNITED KINGDOM Scott Evans, MBChB FRCS (Tr&Orth), UNITED KINGDOM Michael Parry, FRCS, UNITED KINGDOM Jonathan Daniel Stevenson, FRCS (Tr&Orth), UNITED KINGDOM Lee Jeys, FRCS, UNITED KINGDOM
Single Femoral Tunnel For PCL And MCL Reconstruction Using Autografts- 2 Year Follow Up ePoster Presentation Munis Ashraf Keyi, MBBS, DNB (Orth), FASM, FSRM, INDIA Santosh Sahanand Kulasekaran, MBBS,MS(ortho), INDIA David V. Rajan, MS(Orth), MNAMS(Orth), FRCS(G), INDIA
Posterior Stress Radiographs In Internal Or External Rotation Do Not Add Any Value In The Diagnosis Of Combined Posterior Cruciate Ligament And Peripheral Knee Injuries. ePoster Presentation Thorben Briese, MD, GERMANY Romy Riemer, MD, GERMANY Elmar Herbst, MD, PhD, GERMANY Johannes Glasbrenner, MD, GERMANY Christian Peez, MD, GERMANY Andre Frank, MSc, GERMANY Jens Wermers, MD, GERMANY Michael J. Raschke, MD, Prof., GERMANY Christoph Kittl, MD, MD(res), GERMANY
Analysis Of Post-Operative Osteoblastic Activity Patterns In Unicondylar Knee Arthroplasties Slated For Revision ePoster Presentation Félix Dandois, MSc, BELGIUM Lucas Beckers, MD, BELGIUM Hilde Vandenneucker, MD, PhD, Prof, BELGIUM Lennart Scheys, PhD, Prof., BELGIUM
Biomechanical Analysis Of Tissue Engineering Construct For Articular Cartilage Restoration - A Pre-Clinical Study ePoster Presentation Rafaella Rogatto De Faria, PhD, BRAZIL Joao Paulo Cortez Santanna, MD, MSc, BRAZIL Marina J. S. Maizato, PhD, BRAZIL Carla Pinheiro, MSc, BRAZIL Hugo Moreira, MD, BRAZIL Roberto Bortolussi, PhD, BRAZIL Cyro Albuquerque, Prof., PhD, BRAZIL Idagene A. Cestari, PhD, BRAZIL Arnaldo J. Hernandez, MD, PhD, BRAZIL Tiago Lazzaretti Fernandes, MD, PhD, MSc, Post-Doctorate, BRAZIL
Radiological Spine Positioning On The Tibial Plateau And The Implications For Hto Planning Abstract Presentation 6 minutes Wouter Van Genechten, MD, BELGIUM Gino Mestach, MD, BELGIUM Annemieke Van Haver, PhD, MSc, BELGIUM Jozef Michielsen, MD, PhD, BELGIUM Peter Verdonk, MD, PhD, BELGIUM Steven Claes, MD, PhD, BELGIUM
Minimal Clinically Important Difference (MCID) In WOMAC Score And Factors Related To Achievement Of WOMAC Score MCID After Medial Opening Wedge High Tibial Osteotomy For Knee Osteoarthritis ePoster Presentation Dong-Chul Park, MD, KOREA, REPUBLIC OF Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Yong Gyu Sung, MD, KOREA, REPUBLIC OF Jae Jung Kim, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Influence of Patellofemoral Anatomy on Outcomes of Isolated Medial Patellofemoral Ligament Reconstruction for Patellar Instability ePoster Presentation Robert A Magnussen, MD, MPH, UNITED STATES Nicholas Pappa, BS, UNITED STATES Joseph M Long, BS, UNITED STATES Robert A. Duerr, MD, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
High Mid-Term Survival Of Condyle Resurfacing Implants In The Knee – A Nation-Wide Cohort Study On 379 Observations From The Danish Knee Arthroplasty Registry Abstract Presentation 6 minutes Bjørn Borsøe Christensen, MD, PhD, DENMARK Anders El-Galaly, MD, PhD, DENMARK Jens Ole Laursen, Consultant, DENMARK Martin Lind, MD, PhD, Prof., DENMARK
Rotational Reference Axes in TKA ePoster Presentation Johncy Panicker, MBBS, MS, INDIA Amritaraj Satheesh, MBBS,MS, INDIA Balu C Babu, MBBS, MS, INDIA Mohan Thadi, MS DNB FRCS MCh, INDIA Jai Thilak Kailathuvalapil, MS, MCh, FRCS, INDIA
25 Year Function After Proximal Tibial Osteotomy: Paired Outcomes In Patients With Bilateral Tkas Following Unilateral Osteotomy Abstract Presentation 5 minutes Mario Hevesi, MD, PhD, UNITED STATES Ryan R Wilbur, BS, UNITED STATES Lucas K Keyt, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Daniel Saris, MD, PhD, Prof., UNITED STATES Michael J. Stuart, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Incidence Of Meniscal Ramp Lesion In 824 Anterior Cruciate Ligament Reconstruction ePoster Presentation Vitor Barion Castro De Padua, PhD, BRAZIL Felipe Galvão Abreu, MD, BRAZIL Sergio Marinho De Gusmão Canuto, BRAZIL
Performing A Concomitant Tibial Tubercle Osteotomy During Primary Medial Patellofemoral Ligament Reconstruction Does Not Lead To Increased Post-Operative Complication Rates Abstract Presentation 5 minutes Adam Money, MD, UNITED STATES Seth L. Sherman, MD, UNITED STATES Kunal Varshneya, BS, UNITED STATES Andrew Gudeman, MD, UNITED STATES Kevin G. Shea, MD, UNITED STATES
Predictive Signs Of Peripheral Rim Instability With Magnetic Resonance Imaging In No-Shift-Type Complete Discoid Lateral Meniscus Abstract Presentation 5 minutes Yusuke Hashimoto, MD, PhD, JAPAN Kazuya Nishino, MD, JAPAN Shinya Yamasaki, MD, PhD, JAPAN Yohei Nishida, MD, JAPAN Hiroaki Nakamura, MD, PhD, JAPAN
The Body Mass Index And The J-Sign Determine The Quality Of Life In Patients With Lateral Patellar Instability Abstract Presentation 6 minutes Danko Dan Milinkovic, MD, GERMANY Isidora Jovandic, MSc, SERBIA Felix Zimmermann, MD, GERMANY Peter Balcarek, MD, PhD, GERMANY
The Knee Joint Meniscus Is A Shock Absorber Abstract Presentation 6 minutes Andreas M. Seitz, PhD, GERMANY Daniela Warnecke, PhD, GERMANY Jonas Schwer, M. Sc., GERMANY Anita Ignatius, Prof. Dr., GERMANY Lutz Dürselen, Prof. Dr., GERMANY
2 Year Outcomes of Lateral Meniscal Oblique Radial Tear (LMORT) Repair at the Time of ACL Reconstruction Surgery ePoster Presentation Erik Therrien, MD, MSc, FRCSC, CANADA Bryant M. Song, MS, UNITED STATES Ryan R Wilbur, BS, UNITED STATES Michael J. Stuart, MD, UNITED STATES Christopher L. Camp, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES

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Adipose-Derived Culture-Expanded Mesenchymal Stem Cells Implantation for Focal Knee Lesions Improves Radiological and Clinical Outcomes

Adipose-Derived Culture-Expanded Mesenchymal Stem Cells Implantation for Focal Knee Lesions Improves Radiological and Clinical Outcomes

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Adipose-Derived Culture-Expanded Mesenchymal Stem Cells Implantation for Focal Knee Lesions Improves Radiological and Clinical Outcomes

Adipose-Derived Culture-Expanded Mesenchymal Stem Cells Implantation for Focal Knee Lesions Improves Radiological and Clinical Outcomes