Background Osteoarthritis (OA) describes age-related, heterogeneous group of disorders characterized pathologically by focal areas of loss of articular cartilage in synovial joints, associated with varying degrees of osteophyte formation, subchondral bone change, and synovitis. Currently, cartilage repair remains a major challenge for physicians, being avascular with limited regenerative capacity. Stem cell therapy opened new horizons for hyaline cartilage repair. Peripheral blood stem cells (PBSC) due to their multi-lineage potential, immunosuppressive activities, limited immunogenicity, were tried as intra articular injection
Objectives To find out the regenerative effect of repeated intra articular injection of autologous PBSC in knee joints of OA patients by a non invasive technique
Methods The research carried out here with human subjects was in compliance with the Helsinki Declaration. 10 Egyptian patients (3 males and 7 females) diagnosed with bilateral knee joints OA were included in this study, they underwent full history taking, clinical examination, WOMAC index, 6 minutes walking distance test 6, and MRI cartilage imaging by using the semi-quantitative whole joint assessment score of knee for OA (MOAKS). Three intra articular injections of 8 ml of autologous PBSC in each knee after enhancement in quartz tube in a custom made machine. Patent application number: 2011101817. Clinical and radiological assessments were repeated after 1 year.
Results Post injection WOMAC index sections revealed a significant reduction in all parameters. 6 MWD was increase by more than 54 meters. Improvement was expressed as percentage of change of the maximum scores. MR images analysis showed that the mean % of change of the maximum score of full thickness cartilage loss was 44 + 27.
Total WOMAC index was significantly inversely correlated with % of change of maximum score of full thickness cartilage loss; denoting cartilage repair (r= -0.073, P≤0.05).
Conclusions Limited good level of evidence showed that repeated intra-articular injection of autologous PBSC resulted in improvement of the quality of articular cartilage repair and physical function as observed from the MRI and clinical assessment. Keywords: cartilage repair, intra-articular injection autologous PBSC,WOMAC index, MRI cartilage imaging
Acknowledgements We are appreciating dr. Sayed ElOkda for his effort in doing the statistics needed for addressing these results
Disclosure of Interest None declared
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