Bone marrow mesenchymal stem cells in the treatment of patients with knee osteoarthritis

Background. The use of mesenchymal stem cells (MSCs) in joint lesions is an extremely controversial issue due to the presence of numerous unresolved problems both in understanding the biological properties of MSCs and in terms of their practical application. The purpose of the study was to evaluate the functional results and clinical efficacy of using autologous MSCs obtained from bone marrow in the treatment of patients with post-traumatic osteoarthritis (PTOA) of the knee joint (KS) in the early stages, during a six-month observation period. Materials and methods. 28 patients with PTOA of the knee joint of stage I–II according to Kellgren-Lawrence were treated. Among them, 11 (39.0 %) were men and 17 (61.0 %) were women, the average age was 44.80 ± 10.95 years. The average period after the injury was 7.8 ± 0.5 years. MSCs were harvested from the iliac wing and cultured in a biotechnology laboratory. Intra-articular injection was performed once during exacerbation of PTOA (50 million cells). Efficacy was assessed after 6 months. Evaluation criteria: need for NSAIDs, number of exacerbations of PTOA; functional status of the joint according to Lisholm and WOMAC. Pain syndrome was assessed using the visual analog scale (VAS), quality of life according to the 36-Item Short Form Survey (SF-36) scale. Results. After 6 months after the use of MSC, positive dynamics were obtained in all categories of assessment of the functional status of the knee joint: pain according to VAS decreased to 2.2 ± 0.3 (p < 0.05); functional activity according to the Lisholm scale increased by 29.4 % (p < 0.01), the total WOMAC index decreased by 51.7 % (p < 0.01); the quality of life index increased by 57.7 ± 9.3 % when assessed using ­SF-36 (p < 0.01). In addition, during the 6-month clinical observation period following the use of MSCs, a significant decrease in the frequency of exacerbations of PTOA compared to the previous 6-month period and a decrease in the need for NSAIDs were demonstrated. Conclusion. MSCs are an effective and safe method of treating PTOA of the knee in the early stages, accompanied by a significant decrease in pain syndrome indicators, improvement in joint function and quality of life, as well as a decrease in the number of PTOA exacerbations and the need for NSAIDs for at least 6 months.