CURATIVE EFFECT OF HUMAN UMBILICAL CORD MESENCHYMAL STEM CELLS BY INTRA-ARTICULAR INJECTION FOR DEGENERATIVE KNEE OSTEOARTHRITIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGYali ^1,2 , JINWenxiao ² , LIUHaiyan ² , CUIYuhua ² , MAOQingcong ² , FEIZhongying ² ,  XIANGChunsheng ¹

1. Medicine School of Zhejiang University, Hangzhou Zhejiang, 310058, P. R. China;
2. Biological Therapy Center of Zhejiang Armed Police Corps Jiaxing Hospital;

Corresponding?author：

XIANGChunsheng, Email: cxiang@zju.edu.cn

Keywords：

Knee; Degenerative osteoarthritis; Human umbilical cord mesenchymal stem cells; Sodium hyaluronate; Intra-articular injection

DOI：

10.7507/1002-1892.20160305

Video：

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Objective To investigate the safety and efficacy of human umbilical cord mesenchymal stem cells (MSCs) by intra-articular injection for degenerative knee osteoarthritis. Methods Between January 2015 and January 2016, 36 patients with moderate or severe degenerative knee osteoarthritis were randomly devided into 2 groups (n=18). Intra-articular injection of 2.5-3.0 mL human umbilical cord MSCs suspension containing (2-3)×10⁷ cells was performed once a month for 2 times as a course of treatment in the cell treatment group; sodium hyaluronate by intra-articular injection was used once a week for 5 times as a course of treatment in the control group. There was no significant difference in gender, age, body mass index, side, stage of osteoarthritis, course of disease, and preoperative Lysholm score of the knee joint, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and SF-36 scale score between 2 groups (P > 0.05). The clinical efficacy was evaluated by SF-36 scale score, Lysholm score, and WOMAC score. Results All patients of 2 groups received a course of treatment. The patients were followed up for 6 months. After injection, the incidences of pain and swelling in the cell treatment group were significantly higher than those in the control group (χ²=16.200, P=0.000; χ²=11.688, P=0.000), but no significant difference was found in the incidence of effusion (χ²=2.118, P=0.146). In the cell treatment group, Lysholm score at 1-6 months after treatment, WOMAC score and SF-36 scale score at 2-6 months after treatment were significantly better when compared with scores before treatment (P < 0.05), and no recurrence of knee pain was observed during follow-up. In the control group, there was no significant difference in Lysholm score and SF-36 scale score between pre-and post-treatment (P > 0.05); there were significant differences in WOMAC score between pre-treatment and at 1, 2, 3 months after treatment (P < 0.05); at 3 months after treatment, 11 patients had joint pain symptoms again. No significant difference was found in the knee joint function score and SF-36 scale score at 1 and 2 months after treatment between 2 groups (P > 0.05), but the scores of the cell treatment group were significantly better than those of the control group at 3 and 6 months (P < 0.05). Conclusion It can significantly improve the joint function and quality of life to use intra-articular injection of human umbilical cord MSCs for treating degenerative knee osteoarthritis. It takes effect after 1 month and the treatment effect can be sustained for 6 months.

Citation： WANGYali, JINWenxiao, LIUHaiyan, CUIYuhua, MAOQingcong, FEIZhongying, XIANGChunsheng. CURATIVE EFFECT OF HUMAN UMBILICAL CORD MESENCHYMAL STEM CELLS BY INTRA-ARTICULAR INJECTION FOR DEGENERATIVE KNEE OSTEOARTHRITIS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(12): 1472-1477. doi: 10.7507/1002-1892.20160305 Copy

1.	吳成愛, 趙丹慧, 張硯卓, 等.骨科退行性疾病臨床與生物樣本整合平臺的建立.中華骨科雜志, 2016, 36(5):271-276.
2.	路瑩, 車明學, 張震宇, 等.玻璃酸鈉聯合曲安奈德治療中老年膝關節炎的療效.中國老年學雜志, 2014, 34(21):6208-6209.
3.	王黎明, 王立華, 李銘, 等.臍帶間充質干細胞移植對類風濕性關節炎患者行管炎性因子影響的探討.中國免疫學雜志, 2014, 30(8):1059-1063.
4.	王亞莉, 齊江彤, 崔玉華, 等.人臍帶間充質干細胞移植治療強直性脊柱炎.免疫學雜志, 2015, 31(1):90-92.
5.	Uth K, Trifonov D. Stem cell application for osteoarthritis in the knee joint:A minireview. World J Stem Cells, 2014, 6(5):629-636.
6.	Orth P, Rey-Rico A, Venkatesan JK, et al. Current perspectives in stem cell research for knee cartilage repair. Stem Cells Cloning, 2014, 7:1-17.
7.	王向輝, 丁瓊浩.膝骨關節炎的骨髓間充質干細胞療法.現代中西醫結合雜志, 2015, 24(4):451-453.
8.	于洋, 李鴻斌.透明質酸誘導骨髓間充質干細胞治療骨性關節炎軟骨分化研究進展.內蒙古醫學雜志, 2013, 45(4):438-441.
9.	Freitag J, Bates D, Boyd R, et al. Mesenchymal stem cell therapy in the treatment of osteoarthritis:reparative pathways, safety and efficacy-a review. BMC Musculoskelet Disord, 2016, 17:230.
10.	Wolfstadt JI, Cole BJ, Ogilvie-Harris DJ, et al. Current concepts:the role of mesenchymal stem cells in the management of knee osteoarthritis. Sports Health, 2015, 7(1):38-44.
11.	Chen G, Wang Y, Xu Z, et al. Neural stem cell-like cells derived from autologous bone mesenchymal stem cells for the treatment of patients with cerebral palsy. J Transl Med, 2013, 11:21.
12.	王亞莉, 陳國軍, 方鳳, 等.腦癱患者骨髓間充質干細胞體外培養特性分析.山東醫藥, 2012, 52(23):8-10.
13.	劉時璋, 凌鳴, 易智, 等.間充質干細胞在兔骨關節炎關節腔內移植的研究.陜西醫學雜志, 2013, 42(11):1450-1452.
14.	羅玉明, 鄭維篷, 魏合偉.骨關節炎與細胞因子TNF-α、IL-6關系的研究進展.現代診斷與治療, 2013, 24(2):326-327.
15.	潘建科, 郭達, 劉軍, 等.白細胞介素-10與骨關節炎相關性的研究進展.廣東醫學, 2016, 37(1):146-148.
16.	康麗莉, 于立耘, 倪軍, 等.臍帶間充質干細胞移植對膠原誘導型關節炎大鼠炎性趨化因子表達的影響.血栓與止血學, 2012, 18(6):247-250.
17.	林傳明, 顧健, 張育, 等.臍帶間充質干細胞移植對膠原誘導型關節炎大鼠免疫相關易栓狀態的干預作用.中華血液學雜志, 2012, 33(3):215-219.
18.	金瑛, 李豫皖, 張承昊, 等.體外誘導人羊膜間充質干細胞向韌帶細胞分化的實驗研究.中國修復重建外科雜志, 2016, 30(2):237-244.

1. 吳成愛, 趙丹慧, 張硯卓, 等.骨科退行性疾病臨床與生物樣本整合平臺的建立.中華骨科雜志, 2016, 36(5):271-276.
2. 路瑩, 車明學, 張震宇, 等.玻璃酸鈉聯合曲安奈德治療中老年膝關節炎的療效.中國老年學雜志, 2014, 34(21):6208-6209.
3. 王黎明, 王立華, 李銘, 等.臍帶間充質干細胞移植對類風濕性關節炎患者行管炎性因子影響的探討.中國免疫學雜志, 2014, 30(8):1059-1063.
4. 王亞莉, 齊江彤, 崔玉華, 等.人臍帶間充質干細胞移植治療強直性脊柱炎.免疫學雜志, 2015, 31(1):90-92.
5. Uth K, Trifonov D. Stem cell application for osteoarthritis in the knee joint:A minireview. World J Stem Cells, 2014, 6(5):629-636.
6. Orth P, Rey-Rico A, Venkatesan JK, et al. Current perspectives in stem cell research for knee cartilage repair. Stem Cells Cloning, 2014, 7:1-17.
7. 王向輝, 丁瓊浩.膝骨關節炎的骨髓間充質干細胞療法.現代中西醫結合雜志, 2015, 24(4):451-453.
8. 于洋, 李鴻斌.透明質酸誘導骨髓間充質干細胞治療骨性關節炎軟骨分化研究進展.內蒙古醫學雜志, 2013, 45(4):438-441.
9. Freitag J, Bates D, Boyd R, et al. Mesenchymal stem cell therapy in the treatment of osteoarthritis:reparative pathways, safety and efficacy-a review. BMC Musculoskelet Disord, 2016, 17:230.
10. Wolfstadt JI, Cole BJ, Ogilvie-Harris DJ, et al. Current concepts:the role of mesenchymal stem cells in the management of knee osteoarthritis. Sports Health, 2015, 7(1):38-44.
11. Chen G, Wang Y, Xu Z, et al. Neural stem cell-like cells derived from autologous bone mesenchymal stem cells for the treatment of patients with cerebral palsy. J Transl Med, 2013, 11:21.
12. 王亞莉, 陳國軍, 方鳳, 等.腦癱患者骨髓間充質干細胞體外培養特性分析.山東醫藥, 2012, 52(23):8-10.
13. 劉時璋, 凌鳴, 易智, 等.間充質干細胞在兔骨關節炎關節腔內移植的研究.陜西醫學雜志, 2013, 42(11):1450-1452.
14. 羅玉明, 鄭維篷, 魏合偉.骨關節炎與細胞因子TNF-α、IL-6關系的研究進展.現代診斷與治療, 2013, 24(2):326-327.
15. 潘建科, 郭達, 劉軍, 等.白細胞介素-10與骨關節炎相關性的研究進展.廣東醫學, 2016, 37(1):146-148.
16. 康麗莉, 于立耘, 倪軍, 等.臍帶間充質干細胞移植對膠原誘導型關節炎大鼠炎性趨化因子表達的影響.血栓與止血學, 2012, 18(6):247-250.
17. 林傳明, 顧健, 張育, 等.臍帶間充質干細胞移植對膠原誘導型關節炎大鼠免疫相關易栓狀態的干預作用.中華血液學雜志, 2012, 33(3):215-219.
18. 金瑛, 李豫皖, 張承昊, 等.體外誘導人羊膜間充質干細胞向韌帶細胞分化的實驗研究.中國修復重建外科雜志, 2016, 30(2):237-244.

Chinese Journal of Reparative and Reconstructive Surgery

CURATIVE EFFECT OF HUMAN UMBILICAL CORD MESENCHYMAL STEM CELLS BY INTRA-ARTICULAR INJECTION FOR DEGENERATIVE KNEE OSTEOARTHRITIS

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