Minimally invasive cell-based therapy for symptomatic bone marrow lesions of the knee: A prospective clinical study at 1 year.
Minimally invasive cell-based therapy for symptomatic bone marrow lesions of the knee: A prospective clinical study at 1 year.
复制标题
针对膝关节症状性骨髓病变的微创细胞疗法：一项为期 1 年的前瞻性临床研究。
DOI：
10.1089/scd.2021.0283
复制
发表时间：
2022
影响因子：
4
通讯作者：
A. Gobbi
中科院分区：
文献类型：
--
作者：
Ignacio Dallo;R. D’Ambrosi;D. Szwedowski;A. Mobasheri;A. Gobbi
骨髓病变 (BML) 是磁共振成像 (MRI) 中常见的不同病理表现，例如自发性机能不全性骨折、骨坏死、短暂性 BML 综合征、骨关节炎和创伤。多种情况下 BML 的病因和演变仍不清楚。目前尚无治疗膝关节症状性 BML 的金标准方案。骨核心成形术的生物增强是一种新的治疗方式，显示出有希望的效果，可以减轻疼痛，从而阻止疾病的进展。这项前瞻性研究的目的是报告骨核心成形术治疗膝关节症状性 BML 的临床结果和安全性。研究纳入了 15 名患有膝关节 BML 症状且接受骨核心成形术治疗的患者，并进行了至少 12 个月的前瞻性随访。每个患者在手术前以及手术后 6 个月和 12 个月时分别使用 Tegner 评分、Marx 评分、国际膝关节文献委员会 (IKDC)、膝关节损伤和骨关节炎结果评分 (KOOS) 进行评估，该评分分为疼痛、日常生活活动 (ADL) 和生活质量 (QOL) 分量表以及疼痛视觉模拟量表 (VAS)。除 Tegner 和 Marx 评分外，所有临床评分在整个随访期间均显示出总体统计显着性改善（p<0.05），并且在每个随访期之间（T0 与 T1；T0 与 T2；T1 与 T2）之间都有显着改善（p<0.05）。没有并发症的报道。这些初步结果证实，在 1 年随访中，通过 Osteo Core Plasty 技术进行生物软骨下骨增量是一种安全有效的微创治疗方案，用于治疗膝关节症状性 BML。未来仍需要高质量的随机对照试验研究和系统评价，以加强预防或治疗膝关节 BML 的进一步治疗策略。
Bone Marrow Lesions (BMLs) are typical findings in magnetic resonance imaging (MRI) present in different pathologies, such as spontaneous insufficiency fractures, osteonecrosis, transient BML syndromes, osteoarthritis, and trauma. The etiology and evolution of BMLs in multiple conditions remain unclear. There is still no gold standard protocol for the treatment of symptomatic BMLs in the knee. The biologic augmentation by Osteo Core Plasty is a new treatment modality showing promising results reducing pain with the aim to stop the progression of the disease. The purpose of this prospective study is to report the clinical outcomes and safety of Osteo Core Plasty for the treatment of symptomatic BMLs in the knee. Fifteen patients with symptomatic BMLs of the knee treated with the Osteo Core Plasty technique were included and followed prospectively for a minimum of 12 months. Each patient was evaluated before the surgery and respectively at 6 and 12 months using the Tegner Score, Marx Score, the International Knee Documentation Committee (IKDC), the Knee Injury and Osteoarthritis Outcome Score (KOOS) divided in pain, activity daily living (ADL) and Quality of Life (QOL) subscale and the Visual Analogue Scale (VAS) for pain. All clinical scores except Tegner and Marx score showed an overall statistically significant improvement through the entire follow-up (p<0.05) and a significant improvement (p<0.05) between each follow-up period (T0 versus T1; T0 versus T2; T1 versus T2). No complications were reported. These preliminary results confirm that biological subchondral bone augmentation by Osteo Core Plasty technique is a safe and effective minimally invasive treatment option for symptomatic BMLs in the knee at 1-year follow-up. There is still a need for high-quality RCTs studies and systematic reviews in the future to enhance further treatment strategies in preventing or treating BMLs of the knee.