title: Treatment of knee osteoarthritis with autologous mesenchymal stem cells: a pilot study.
abstract: BACKGROUND
  Osteoarthritis is the most prevalent joint disease and a frequent cause of joint pain, functional loss, and disability. Osteoarthritis often becomes chronic, and conventional treatments have demonstrated only modest clinical benefits without lesion reversal. Cell-based therapies have shown encouraging results in both animal studies and a few human case reports. We designed a pilot study to assess the feasibility and safety of osteoarthritis treatment with mesenchymal stromal cells (MSCs) in humans and to obtain early efficacy information for this treatment.
  
  
  METHODS
  Twelve patients with chronic knee pain unresponsive to conservative treatments and radiologic evidence of osteoarthritis were treated with autologous expanded bone marrow MSCs by intra-articular injection (40×10 cells). Clinical outcomes were followed for 1 year and included evaluations of pain, disability, and quality of life. Articular cartilage quality was assessed by quantitative magnetic resonance imaging T2 mapping.
  
  
  RESULTS
  Feasibility and safety were confirmed, and strong indications of clinical efficacy were identified. Patients exhibited rapid and progressive improvement of algofunctional indices that approached 65% to 78% by 1 year. This outcome compares favorably with the results of conventional treatments. Additionally, quantification of cartilage quality by T2 relaxation measurements demonstrated a highly significant decrease of poor cartilage areas (on average, 27%), with improvement of cartilage quality in 11 of the 12 patients.
  
  
  CONCLUSIONS
  MSC therapy may be a valid alternative treatment for chronic knee osteoarthritis. The intervention is simple, does not require hospitalization or surgery, provides pain relief, and significantly improves cartilage quality.
authors.affiliation: Institut de Teràpia Regenerativa Tissular (ITRT), Centro Médico Teknon, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Orozco
authors.forename: Anna
authors.initials: A
authors.lastname: Munar
authors.forename: Robert
authors.initials: R
authors.lastname: Soler
authors.forename: Mercedes
authors.initials: M
authors.lastname: Alberca
authors.forename: Francesc
authors.initials: F
authors.lastname: Soler
authors.forename: Marina
authors.initials: M
authors.lastname: Huguet
authors.forename: Joan
authors.initials: J
authors.lastname: Sentís
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez
authors.forename: Javier
authors.initials: J
authors.lastname: García-Sancho
mesh_terms: D000328:Adult; D001854:Bone Marrow Cells / Q000166:cytology; D002356:Cartilage / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059630:Mesenchymal Stem Cells / Q000166:cytology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000628:therapy*; D010147:Pain Measurement; D010865:Pilot Projects; D011788:Quality of Life; D016896:Treatment Outcome