Osteochondral lesions of the knee reconstructed with mesenchymal stem cells - results.

BACKGROUND We present the results of the treatment of osteochondral lesions with the modified sandwich technique with a collagen membrane. The aim of the study was to assess and compare clinical outcomes following the reconstruction of osteochondral lesions in two groups of patients treated with stem cells obtained from blood and with bone marrow concentrate.

MATERIAL AND METHODS The study group comprised 46 patients with MRI-confirmed osteochondral lesions of various aetiology. A group of 21 patients was treated with bone marrow concentrate and 25 patients were treated with mesenchymal cells obtained from peripheral blood. Patients were assessed with the use of KOOS, Lysholm and VAS scales at 6 months, and at 1 and 5 years following the reconstruction.

RESULTS We noted a significant improvement across all scales in 40 patients (86%). A poor outcome was noted in 6 patients. There was a statistically significant superiority of the group treated with stem cells obtained from blood. The analysis of MRI evidence in patients with good and excellent results showed satisfactory reconstruction of the cartilaginous surface and good regenerate integration. At 5 years, a slight decrease in mean clinical assessment scores was seen in both groups of patients.

CONCLUSIONS 1. The modified sandwich reconstruction is an effective modality in the treatment of severe osteochondral lesions of the knee. 2. Slightly poorer outcomes in the group treated with bone marrow concentrate may have resulted from the number of injected stem cells.