Comparison of the Efficacy of Human Umbilical Cord-Derived and Bone Marrow Aspirate Concentrate Mesenchymal Stem Cells for Cartilage Repair Defects of the Knee via Arthroscopic Implementation on Scaffolds in a Retrospective Study

Abstract

Injuries to the articular cartilage of the human knee joint, commonly resulting from trauma, inflammation, or age- and activity-related wear and tear, have significant implications, primarily leading to osteoarthritis (OA). Conservative treatments for such injuries often yield suboptimal clinical outcomes. Surgical interventions using current methods may not consistently provide satisfactory results, largely due to the formation of low-quality scar tissue lacking the biomechanical properties of hyaline cartilage. In this retrospective study, we compared the results of two promising methods for regenerating cartilage defects in the knee joints using scaffolds soaked with stem cells of different origins: bone marrow aspirate concentrate mesenchymal stem cells (BMAC-MSCs) and human umbilical cord-derived mesenchymal stem cells (hUCB-MSCs). We evaluated 39 patients (39 knees, hUCB-MSCs: 20 knees, BMAC: 19 knees) at the 12-month follow-up using VAS, KOOS, Lysholm scales and radiologically with M-MOCART 2.0 score. The analysis demonstrated substantial overall improvement in both groups, notably reflected in enhanced quality of life for the patients. Interestingly, the final scores in the hUCB-MSCs group were comparable to those in the BMAC-MSCs group, with no statistically significant differences observed, despite variations in preoperative age and lesion size. Notably, the hUCB-MSCs group consisted of significantly older individuals with larger lesion sizes. Both procedures were found to be safe, and improvement was observed in both groups, which holds promise for future clinical investigations.

Keywords: cartilage; knee; mesenchymal stem cells; regenerative medicine.

Figure 1

Pre-surgery (pre-op) p = 0.971, 6 months (6 M post-op) p = 0.664, and 1 year after the surgery (1 Y post-op) p = 0.104 VAS pain measurements. There was no significant difference between two groups. BMAC-MSCs (n = 20), hUCB-MSCs (n = 19).

Figure 2

Pre-surgery (pre-op) p = 0.102, 6 months (6 M post-op) p = 0.726, and 1 year after the surgery (1 Y post-op) p = 0.471 Lysholm scale functionality of the knee measurements. As described in the text, both groups progressively improved from measurement to measurement and there were no statistically significant differences between groups. BMAC-MSCs (n = 20), hUCB-MSCs (n = 19).

Figure 3

Pre-surgery (pre-op), 6 months (6 M post-op), and 1 year after the surgery (1 Y post-op) KOOS scale functionality of the knee measurements. Other Disease-Specific Symptoms (KOOS S), Pain (KOOS P), ADL (activities of daily living) Function (KOOS A), Sport and Recreation Function (KOOS SP), and knee-related Quality of Life (KOOS Q). BMAC-MSCs (n = 20), hUCB-MSCs (n = 19).

Figure 4

The pre-operation (on the left) versus 12 months post-operation (on the right) MRI images. The patient from the BMAC-MSCs group shows a local chondral lesion (indicated by the red arrow) on the patella. The green arrow highlights the observed effect of the therapy after one year.