2013, Number 3
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Rev Cubana Hematol Inmunol Hemoter 2013; 29 (3)
Impact of the treatment with adult stem cells in knee osteoarthrosis
Cruz-Sánchez PM, Gámez-Pérez A, Rodríguez-Orta CA, González PY, López GE, Pérez MDS, González GJA, González CF, Pérez LI, Baganet CAM, Escarpanter BJC, Mijares MH, Cruz PY
Language: Spanish
References: 21
Page:
PDF size: 166.64 Kb.
ABSTRACT
Introduction: osteoarthrosis an every day more frequent degenerative disease
affecting the quality of life of people over 55 years old and its treatment is a great
challenge. The use of stem cells has open a new alternative in the available therapeutic
arsenal.
Objective: to assess the efficacy and safety of autologous adult stem cell
transplantation in the treatment of knee osteoarthrosis.
Methods: the study took place from May 2009 to December 2011 in 123 adult
patients with OAR from the regenerative medicine outpatient service who had no
response to conventional treatments. Intra-articular implantation of autologous
peripheral blood mononuclear cells (MNC-SP) mobilized by granulocyte colony
stimulating factor was performed. In all cases pain and gait difficulty at baseline
prevailed.
Results: after six months, clinical and radiological improvement in 117 patients (95,1
%) were observed and only in six patients (4,9 %) the expected response was not
obtained. These last patients presented marked alignment disorders and the pain did
not disappear, but there was a positive change in its intensity.
Conclusions: the CMN-SP implant is a feasible, simple, safe and less expensive
method for the treatment of knee osteoarthrosis. It is recommended that in cases with
marked angular deformity, this disorder should be corrected prior to MNC-SP
implantation so the procedure be successful.
REFERENCES
Pacheco Díaz E, Arango García G, Jiménez Paneque R, Aballe Hoyos ZA. Las lesiones intraarticulares de la rodilla evaluadas por artroscopia, su relación con la clínica y la imagenología. Rev. Cubana Ortop Traumatol 2007 [Consultado: 4 Mar 2013] ; 21(2): Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864- 215X2007000200002&lng=es.
Samanta A, Regan M. Prevalencia de la artrosis de rodilla. Br J Rheumatol 2004; 32(3):366-70.
Reddy S, Pedowitz DI, Parekh SG, Sennett BJ, Okereke E. The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus. Am J Sports Med. 2007; 35:80-5.
Muneta T, Koga H, Mochizuki T, Suzuki K, Makino H, Umezawa A, et al. Increased proliferation of human synovial mesenchymal stem cells with autologous human serum: Comparisons with bone marrow mesenchymal stem cells and with fetal bovine serum. Arthritis and Rheumatism. 2008; 58:501-10.
Chang F, Ishii T, Yanai T, Mshima H, Akaogi H, Ogawa T, et al. Repair of large fullthickness articular cartilage defects by transplantation of autologous uncultured bonemarrow- derived mononuclear cells. J Orthop Res. 2008; 26:18-26.
Baganet-Cobas AM, Hernández-Ramírez P, Fernández-Delgado N, Forrellat-Barrios M, González-Iglesias AI, Pérez-Fuentes E, et al. Implante percutáneo de células mononucleares de sangre periférica movilizadas con factor estimulante de colonias granulocíticas, en la osteoartrosis de rodilla. Primer caso comunicado en Cuba. Rev Cubana Hematol Inmunol Hemoter 2010; 26(1)246-52.
Kellgren JH, Lawrence JS. Osteo-arthrosis and disk degeneration in an urban population. Ann Rheumatic Dis. 1958;17:388-97.
Cortina LD, Hernández P, López MR, Artaza H, Dorticós E, Macías C, et al. Aislamiento de células mononucleares de sangre periférica para trasplante de células madre: método simplificado. Rev. Cubana Hematol Inmunol Hemoter 2008 [Consultado: 4 Mar 2013]; 24(3): Disponible en:http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864 - 02892008000300004&lng=es
Yera Nadal JL, Guillén Vargas M, Squire Valdés E, Rodríguez Valdés M, Hernández Luaces LF. Analgesia postoperatoria en la cirugía artroscópica de rodilla. Estudio multicéntrico. Revista Cubana de Anestesiología y Reanimación 2003 [Consultado: 14 Feb 2013]; 2 (2): 31-36. Disponible en:http://bvs.sld.cu/revistas/scar/vol2/no2/index.htm
Álvarez López A, Casanova Morote C, García Lorenzo Y. Tratamiento quirúrgico de la osteoartritis de rodilla. Rev Cubana Ortop Traumatol 2004 [Consultado: 15 Feb 2013]:18(1) Disponible en:http://bvs.sld.cu/revistas/ort/vol18_1_04/ort10104.htm
Bierna-ZeInstra SM, Koes BW. Risk factors and prognostic factors of hip and knee ostearthritis. Nat Clin Pract Rheumatol 2007; 3(2):75-85.
Morasén Cuevas JR, Calisté Manzano O, Vergés Callard Principales aspectos clínicos y endoscópicos de la enfermedad degenerativa de la rodilla. MEDISAN. 2010 Nov-Dic [Consultado: 4 Mar 2013]; 14 (9): 2098 Disponible en: http://bvs.sld.cu/revistas/san/vol_14_9_10/san04910.pdf
Hernández P. Medicina regenerativa y células madre. Mecanismos de acción de las células madre adultas. Rev Cubana Hematol Inmunol Hemoter 2009 [Consultado: 4 Mar 2013]; 25(1). Disponible en:http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864 - 02892009000100002&lng=es
Méndez-Otero R, Freitas de GR, Andre C, Furtado de Mendoca ML, Friedrich M, Olivera-Filho J. Potential roles of bone marrow stem cells in stroke therapy. Regenerative Medicine 2007;2:417-23.
Gnecchi M, Zhang Z, Ni A, Dzau V. Paracrine mechanism in adult stem cell signalling and therapy. Circulation Res 2008;103:1204-19.
Hernández P. Medicina Regenerativa y enfermedades renales. En: Arce Bustabad S. Trasplante Renal y Enfermedad renal crónica. Sistemas de leyes integradoras. La Habana: Ciencias Médicas; 2009. p. 298-323.
Kucia M, Wysoczynski M, Ratajczak J, Ratajczak MZ. Identification of very small embryonic like (VSEL) stem cells in bone marrow. Cell Tissue Res. 2008; 331:125-34.
Reddy S, Pedowitz DI, Parekh SG, Sennett BJ, Okereke E. The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus. Am J Sports Med 2007; 35:80-5.
Whittaker JP, Smith G, Makwana N, Roberts S, Harrison PE, Laing P, et al. Early results of autologous chondrocyte implantation in the talus. J Bone Joint Surgery Br. 2007; 87:179-83.
Muneta T, Koga H, Mochizuki T, Suzuki K, Makino H, Umezawa A, et al. Increased proliferation of human synovial mesenchymal stem cells with autologous human serum: Comparisons with bone marrow mesenchymal stem cells and with fetal bovine serum. Arthritis and Rheumatism 2008;58:501-10.
Tateishi-Yuyama E, Matsubara H, Murohara T, Ikeda V, Shintani S, Masaki H, et al. Therapeutic angiogenesis for patients with limb ischaemia by autologous transplantation of bone marrow cells: A pilot study and a randomized controlled trial. Lancet 2002; 360:427-35.