title: Assessment of clinical and MRI outcomes after mesenchymal stem cell implantation in patients with knee osteoarthritis: a prospective study.
abstract: OBJECTIVE
  Cartilage regenerative procedures using the cell-based tissue engineering approach involving mesenchymal stem cells (MSCs) have been receiving increased interest because of their potential for altering the progression of osteoarthritis (OA) by repairing cartilage lesions. The aim of this study was to investigate the clinical and magnetic resonance imaging (MRI) outcomes of MSC implantation in OA knees and to determine the association between clinical and MRI outcomes.
  
  
  METHODS
  Twenty patients (24 knees) who underwent arthroscopic MSC implantation for cartilage lesions in their OA knees were evaluated at 2 years after surgery. Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and the Tegner activity scale, and cartilage repair was assessed according to the MRI Osteoarthritis Knee Score (MOAKS) and Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score.
  
  
  RESULTS
  The clinical outcomes significantly improved (P < 0.001 for both). The cartilage lesion grades (as described in MOAKS [grades for size of cartilage-loss area and percentage of full-thickness cartilage loss]) at follow-up MRI were significantly better than the preoperative values (P < 0.001 for both). The clinical outcomes at final follow-up were significantly correlated with the MOAKS and MOCART score at follow-up MRI (P < 0.05 for all).
  
  
  CONCLUSIONS
  Considering the encouraging clinical and MRI outcomes obtained and the significant correlations noted between the clinical and MRI outcomes, MSC implantation seems to be useful for repairing cartilage lesions in OA knees. However, a larger sample size and long-term studies are needed to confirm our findings.
authors: Center for Stem Cell & Arthritis Research, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: yskimos@gmail.com.
authors: Y S
authors: YS
authors: Kim
authors: Center for Stem Cell & Arthritis Research, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: ser78@gmail.com.
authors: Y J
authors: YJ
authors: Choi
authors: Department of Radiology, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: swlee@gmail.com.
authors: S W
authors: SW
authors: Lee
authors: Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: osmddragon@hanmail.net.
authors: O R
authors: OR
authors: Kwon
authors: Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: lawnlei@naver.com.
authors: D S
authors: DS
authors: Suh
authors: Center for Stem Cell & Arthritis Research, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: doctorboy@hanmail.net.
authors: D B
authors: DB
authors: Heo
authors: Center for Stem Cell & Arthritis Research, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea; Joint Reconstruction Center, Department of Orthopaedic Surgery, Yonsei Sarang Hospital, Seoul, Republic of Korea. Electronic address: yonggonkoh@gmail.com.
authors: Y G
authors: YG
authors: Koh
mesh_terms: D000368:Aged; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D065466:Lysholm Knee Score; D008279:Magnetic Resonance Imaging; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012720:Severity of Illness Index; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives
keywords: Fibrin glue; Implantation; Knee; Mesenchymal stem cell; Osteoarthritis