Associations of clinical outcomes and MRI findings in intra-articular administration of autologous adipose-derived stem cells for knee osteoarthritis

Junya Higuchi; Ryota Yamagami; Takumi Matsumoto; Tomohiro Terao; Keita Inoue; Shinsaku Tsuji; Yuji Maenohara; Tokio Matsuzaki; Ryota Chijimatsu; Yasunori Omata; Fumiko Yano; Sakae Tanaka; Taku Saito

doi:10.1016/j.reth.2020.04.003

Associations of clinical outcomes and MRI findings in intra-articular administration of autologous adipose-derived stem cells for knee osteoarthritis

Regen Ther. 2020 May 25:14:332-340. doi: 10.1016/j.reth.2020.04.003. eCollection 2020 Jun.

Authors

Affiliations

¹ Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
² Bone and Cartilage Regenerative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
³ Avenue Cell Clinic, Tokyo, Japan.
⁴ Japan Biodesign Program, Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.

Abstract

Introduction: Clinical studies of intra-articular injection of mesenchymal stem cells for osteoarthritis (OA) indicate its efficacy. Here, we retrospectively investigated the associations of pretherapeutic magnetic resonance imaging (MRI) findings with the clinical outcomes up to 6 months, after intra-articular administration of adipose-derived stem cells (ASCs) to knee OA patients.

Methods: We first analyzed alterations of the visual analog scale (VAS) and knee injury and osteoarthritis outcome score (KOOS) in 57 knees of 34 patients from whom clinical scores were obtained before ASC therapy, and at 1, 3, and 6 months. Among the patients, we further examined MRI findings of 34 knees of 19 patients whose pretherapeutic MRI data were available.

Results: The mean improvement of VAS and KOOS-total during 6 months was 2.6 ± 4.0 (from 6.1 ± 2.5 to 3.5 ± 2.9, P < 0.001) and 10.2 ± 12.4 (from 54.4 ± 12.7 to 64.6 ± 13.8, P < 0.01), respectively. Scales related to pain and symptoms improved earlier than those related to activities of daily living (ADL) and sports/recreation. Improvement of VAS and KOOS-sports/recreation was significantly higher in patients with more severe cartilage lesions. Similarly, osteophyte lesions were associated significantly with improvement of VAS and KOOS-ADL, and BML was associated with KOOS-ADL and KOOS-sports/recreation.

Conclusions: In intra-articular administration of autologous ASCs for knee OA, improvement of VAS and KOOS-sports/recreation was significantly higher in patients with more severe cartilage lesions. Similarly, osteophyte lesions were associated significantly with improvement of VAS and KOOS-ADL, and BML was associated with KOOS-ADL and KOOS-sports/recreation. Clinical studies with larger numbers of patients and various kinds of data are necessary to predict therapeutic effects.

Keywords: ADL, activities of daily living; ASC, adipose-derived stem cell; Adipose-derived stem cell; BML, bone marrow lesion; CPC, cell processing center; Intra-articular administration; KOOS; KOOS, knee injury and osteoarthritis outcome score; MCID, minimally clinical important difference; MOAKS; MOAKS, MRI osteoarthritis knee score; MRI, magnetic resonance imaging; MSC, mesenchymal stem cell; OA, osteoarthritis; Osteoarthritis; QOL, quality of life; VAS; VAS, visual analog scale.