Text

Objectives and questions: Knee OA is a leading cause of disability and chronic pain. Rather than disease modification, current medical management procedures for knee OA focus on pain relief and symptom management. Surgical management in the form of joint replacement may be associated with complications.

Mesenchymal stem cell-based therapies(ADMSC) offer a new possibility in the treatment of knee OA and importantly show hope in disease modification, with potential inhibition of the progress of this degenerative process.

Is fat derived stem cells for treatment of knee osteoarthritis a viable option.

Material and methods: The present study was conducted to evaluate the efficacy of intra-articular injection ADMSC in the treatment of mild to moderate degenerative knee osteoarthritis. This study was carried out on 20 patients suffering from mild to moderate knee osteoarthritis who presented to our institute, patients aged from 30 to 65 years with symptomatic primar osteoarthritis. The ADMSC were obtained from the patient own adipose tissue by liposuction. A centrifugation step was carried out and then SVF pellet was aspirated from the syringe and was ready for intra-articular injection.

Results: Intra-articular injection of ADMSC in all patients was associated with statistically significant decrease in the mean WOMAC score from 65.2±4.54 at baseline to 49.5±10.79 at 3 months.

It was found that injection was associated with significant reduction of WOMAC mean score from 65.2±4.54 at baseline to 40.9±6.97 at 6 months with percent of improvement 37.3%. In agreement with this study, Jo CH et al, 2014 reported that AD MSCs injection was associated with improvement of the mean WOMAC score from 54.2±5.2 at baseline to 32.8±6.3 at 6 months with percent of improvement 39%. In a meta-analysis of 11 clinical trials involving a total of 582 patients with knee OA, Yubo et al, 2017 evaluated the clinical efficacy and safety of bone marrow mesenchymal stem cells and ADMSC treatment for knee OA. The investigators demonstrated that ADMSC treatment improved pain and functional scores after a 24-month follow-up compared to controls and were safe with no serious adverse events reported.

Discussion and conclusions: ADMSC based therapies showed safety and effectiveness in the treatment of OA with the ability to relieve pain and improve function in patients with symptomatic knee OA presenting various severities.

The procedure is safe, easy and can be done under local anesthesia Better results were obtained in younger patients with normal weight and mild to moderate OA