Restoration of a large osteochondral defect of the knee using a composite of umbilical cord blood-derived mesenchymal stem cells and hyaluronic acid hydrogel: a case report with a 5-year follow-up.
The treatment of articular cartilage defects is a therapeutic challenge for orthopaedic surgeons. Furthermore, large osteochondral defects needs restoration of the underlying bone for sufficient biomechanical characteristics as well as the overlying cartilage.



A symptomatic large osteochondral defect in the knee joint was restored using a composite of umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) 0.5 x 107/ml and 4% hyaluronic acid (HA) hydrogel. Significant improvements in pain and function of the knee joint were identified by the evaluation at 12 months after surgery. A hyaline-like cartilage completely filled the defect and was congruent with the surrounding normal cartilage as revealed by magnetic resonance imaging (MRI), a second-look arthroscopy and histological assessment. The improved clinical outcomes maintained until 5.5 years. MRI also showed the maintenance of the restored bony and cartilaginous tissues.



This case report suggests that the composite of allogeneic UCB-MSCs and HA hydrogel can be considered a safe and effective treatment option for large osteochondral defects of the knee.
Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.
Yong-Beom
YB
Park
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. chulwon.ha@gmail.com.|Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. chulwon.ha@gmail.com.|Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea. chulwon.ha@gmail.com.
Chul-Won
CW
Ha
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Choong-Hee
CH
Lee
Department of Orthopedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju-si, 63241, South Korea.
Yong-Geun
YG
Park
D000328:Adult; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D020100:Hydrogels / Q000138:chemical synthesis; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D000074403:Meniscectomy; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D011859:Radiography; D024162:Second-Look Surgery; D000070600:Tibial Meniscus Injuries / Q000601:surgery; D014184:Transplantation, Homologous / Q000379:methods
D020100:Hydrogels; D006820:Hyaluronic Acid
Hyaluronic acid; Knee; Large osteochondral defect; Mesenchymal stem cell; Umbilical cord blood