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. 2016 Dec 21;6(3):361-366.
doi: 10.11138/mltj/2016.6.3.361. eCollection 2016 Jul-Sep.

Cell therapy for cartilage defects of the hip

Rodrigo Mardones  1 , Alessio Giai Via  2 , Claudio Jofré  3 , José Minguell  3 , Claudio Rodriguez  2 , Alexander Tomic  2 , Matias Salineros  2
Affiliations

Cell therapy for cartilage defects of the hip

Rodrigo Mardones et al. Muscles Ligaments Tendons J. .

Abstract

Background: Chondral injuries are commonly related to poor clinical outcome, but recent data showed some improvements in function and pain after hip arthroscopy. Cell-based therapies represent an appealing alternative strategy for cartilage regeneration, and interesting results have been recently reported after intra-articular injections of mesenchymal stem cells (MSCs). The results of hip arthroscopy for femoroacetabular impingement (FAI) and intra-articular injections of autologous expanded bone marrow - MSCs (BM-MSCs) are reported in this retrospective study.

Materials and methods: Twenty patients (29 hips) received hip arthroscopy for FAI and focal cartilage injuries or mild to moderate osteoarthrosis (OA). Three intra-articular injections of 20×106 BM-MSCs were injected from 4 to 6 weeks postoperative. The modified Harris Hip score (mHHS), the WOMAC score, the VAIL score and VAS score were administered to all patients.

Results: The mean age of the patients was 51.8 years, and the mean follow-up was 24 months. The median preoperative mHHS, WOMAC and VAIL scores were 64.3, 73 and 56.5 respectively, and they increased to 91, 97 and 83 at final follow up (p<0.05). The VAS score also improved from a median of 6 to 2. Four patients received a THA (13% of the hips) at the median of 9 months post intervention (range 6-36 months). Six patients referred pain after the injection of MSCs, which improved with oral pain killers. No major complications were reported.

Conclusion: BM-MSCc injections in combination with hip arthroscopy may improve the quality of life and functional score in patient with FAI and cartilage injuries which are still not candidate to a THA.

Level of evidence: IV case series.

Keywords: cartilage injuries; femoroacetabular impingement; hip arthroscopy; mesenchymal stem cells; osteoarthrosis; stem cells therapy.

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Figures

Figure 1
Figure 1
Pre-operative X-ray showing femoroacetabular impingement CAM-Type (Wiber angle of 26°; α-angle of 63°) and osteoarthrosis of both hips.
Figure 2
Figure 2
The artro-MRI of the left hip shows chondral injuries at the acetabular side.
Figure 3
Figure 3
Intra-operative images: large grade III and IV chondral defects at the chondro-labral junction.
Figure 4
Figure 4
Bone marrow is aspirated from the anterior iliac crest just before the arthroscopic procedure, and the mononuclear cells are isolated by Lymphoprep™ density gradient.
Figure 5
Figure 5
Postoperative X-ray.
See this image and copyright information in PMC

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