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Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Resultados iniciales de seguridad de células madre mesenquimales derivadas de tejido adiposo para el desgarro del
Parisa Nejati1, Nahid Masoumi Shahre Babak2, Amir Sobhani Eraghi3
1Department of Sports and Exercise Medicine, Hazrat-e Rasool General Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background:
Rotator cuff injuries are the underlying cause of shoulder pain in 65-70 % of the patients over the age of 50. A novel therapeutic approach is stem cell therapy, which promises to heal. This study represents one of the first long-term safety evaluations of autologous adipose-derived mesenchymal stem cells (MSCs) in human subjects with total rotator cuff tear, with a specific focus on potential adverse effects.
Methods:
This study was designed as a pilot safety phase within a broader clinical trial framework. Ten patients with full-thickness rotator cuff tears were enrolled. Autologous mesenchymal stem cells (MSCs), derived from adipose tissue, were injected directly into the torn tendons under ultrasound guidance. Patients were monitored over a 36-month period to assess safety outcomes. These included complete blood count (CBC), inflammatory markers-erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)-radiological imaging (X-ray and MRI), pain assessment via visual analog scale (VAS), and functional status through validated questionnaires.
Results:
No systemic or local adverse events were reported during the 36-month follow-up, indicating a favorable safety profile. The CBC parameters after three years compared to the baseline measurement: hemoglobin [mean = 13.92 (SD = 1.32) vs. 13.85 (1.34)], red blood cells [mean = 4.97 (SD = 0.31) vs. 5.11 (0.31)], white blood cells [mean = 6.05 (SD = 2.06) vs. 6.01 (1.70)], platelets [mean = 248.8 (SD = 2.76) vs. 246.9 (2.50)]. The inflammatory markers were also within the normal range as following: ESR [mean = 7 (SD = 1.22) vs. 6.4 (2.48)] and CRP [mean = 0.2 (SD = 0.70) vs. 0.3 (SD = 0.89)]. Pain intensity and functional status improved compared to baseline: VAS [3.6 (SD = 1.17) vs 8.5 (1.93)], WORC [34.17 (SD = 3.31) vs 47.53 (SD = 2.56)], DASH [32.95 (SD = 2.45) vs 50.71 (SD = 4.34)].The shoulder X-ray and MRI did not show any significant pathology in the soft or bony tissues of the shoulder joint over the follow-ups.
Conclusion:
Injection of autologous MSCs derived from adipose tissue is safe in treating total rotator cuff tear. These findings support the initiation of larger-scale trials to further investigate the therapeutic potential and efficacy of MSCs in tendon regeneration.
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