MR cartilage imaging in assessment of the regenerative power of autologous peripheral blood stem cell injection in knee osteoarthritis

BackgroundOsteoarthritis (OA) describes an 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, and limited immunogenicity, were tried as an intra articular injection.Aim of studyTo find out the regenerative effect of repeated intra articular injections of autologous PBSC in knee joints of OA patients using MR cartilage imaging.Methods10 patients (3 males and 7 females) diagnosed with bilateral knee joints OA were included in this study, they underwent history taking, clinical examination and MR cartilage imaging 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 were administered. Clinical and MRI assessments were repeated after 1 year.ResultsA significant reduction was seen in all parameters post injection. MR images analysis showed increased cartilage thickness in 65 knee joint compartments out of 160 affected compartments.ConclusionLimited good level of evidence showed that repeated intra-articular injections of autologous PBSC resulted in an improvement of the quality of articular cartilage repair and physical function as observed by MRI and clinical assessment.