Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation
Abstract Background Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their carti...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-01-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-016-0048-2 |
| _version_ | 1797321362400870400 |
|---|---|
| author | Yong Sang Kim Moses Lee Yong Gon Koh |
| author_facet | Yong Sang Kim Moses Lee Yong Gon Koh |
| author_sort | Yong Sang Kim |
| collection | DOAJ |
| description | Abstract Background Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their cartilage regeneration ability. The purpose of this study was to compare the clinical, radiological, and second‐look arthroscopic outcomes between MSC injection with marrow stimulation and marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. Methods In this retrospective study, 62 patients (64 ankles) with varus ankle osteoarthritis underwent second‐look arthroscopy at a mean of 12.8 months after arthroscopic marrow stimulation combined with SMO; 33 ankles were subjected to marrow stimulation alone (group I), and 31 were subjected to marrow stimulation with MSC injection (group II). Clinical outcome measures included a visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiological outcome variables included the tibial–ankle surface (TAS), talar tilt (TT), and tibial–lateral surface (TLS) angles. In second‐look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. Results The mean VAS score improved significantly from 7.2 ± 1.0 to 4.7 ± 1.4 in group I and from 7.3 ± 0.8 to 3.7 ± 1.5 in group II at the final follow‐up (P < 0.001 for both groups). The mean AOFAS score also improved significantly from 61.7 ± 5.8 to 80.9 ± 6.7 in group I and from 60.6 ± 6.1 to 85.2 ± 5.1 in group II at the final follow‐up (P < 0.001 for both groups). There were significant differences in the mean VAS and AOFAS scores between groups at the final follow‐up (P = 0.002 and 0.010, respectively). At second‐look arthroscopy, there were significant differences in ICRS grades between groups(P = 0.015 for medial aspect of the talar dome, P = 0.044 for medial aspect of the tibial plafond, and P = 0.005 for articular surface of the medial malleolus). ICRS grades were significantly correlated with clinical outcomes in both groups (all P < 0.05). Mean TAS, TT, and TLS angles improved significantly after SMO in both groups but were not significantly correlated with clinical outcomes or ICRS grade (all n.s.). Conclusions The clinical and second‐look arthroscopic outcomes of MSC injection with marrow stimulation were better compared to those of marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. Furthermore, the ICRS grade is significantly correlated with clinical outcome. |
| first_indexed | 2024-03-08T04:57:29Z |
| format | Article |
| id | doaj.art-76490489a32140b2a26802979d0fe1d1 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T04:57:29Z |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-76490489a32140b2a26802979d0fe1d12024-02-07T15:05:53ZengWileyJournal of Experimental Orthopaedics2197-11532016-01-0131n/an/a10.1186/s40634-016-0048-2Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluationYong Sang Kim0Moses Lee1Yong Gon Koh2Department of Orthopaedic SurgeryCenter for Stem Cell & Arthritis ResearchYonsei Sarang Hospital478‐3, Bangbae‐dongSeoulSeocho‐guKoreaDepartment of Orthopaedic SurgeryCenter for Stem Cell & Arthritis ResearchYonsei Sarang Hospital478‐3, Bangbae‐dongSeoulSeocho‐guKoreaDepartment of Orthopaedic SurgeryCenter for Stem Cell & Arthritis ResearchYonsei Sarang Hospital478‐3, Bangbae‐dongSeoulSeocho‐guKoreaAbstract Background Supramalleolar osteotomy (SMO) is reported to be an effective treatment for varus ankle osteoarthritis by redistributing the load line within the ankle joint. Mesenchymal stem cells (MSCs) have been proposed as a new treatment option for osteoarthritis on the basis of their cartilage regeneration ability. The purpose of this study was to compare the clinical, radiological, and second‐look arthroscopic outcomes between MSC injection with marrow stimulation and marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. Methods In this retrospective study, 62 patients (64 ankles) with varus ankle osteoarthritis underwent second‐look arthroscopy at a mean of 12.8 months after arthroscopic marrow stimulation combined with SMO; 33 ankles were subjected to marrow stimulation alone (group I), and 31 were subjected to marrow stimulation with MSC injection (group II). Clinical outcome measures included a visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiological outcome variables included the tibial–ankle surface (TAS), talar tilt (TT), and tibial–lateral surface (TLS) angles. In second‐look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. Results The mean VAS score improved significantly from 7.2 ± 1.0 to 4.7 ± 1.4 in group I and from 7.3 ± 0.8 to 3.7 ± 1.5 in group II at the final follow‐up (P < 0.001 for both groups). The mean AOFAS score also improved significantly from 61.7 ± 5.8 to 80.9 ± 6.7 in group I and from 60.6 ± 6.1 to 85.2 ± 5.1 in group II at the final follow‐up (P < 0.001 for both groups). There were significant differences in the mean VAS and AOFAS scores between groups at the final follow‐up (P = 0.002 and 0.010, respectively). At second‐look arthroscopy, there were significant differences in ICRS grades between groups(P = 0.015 for medial aspect of the talar dome, P = 0.044 for medial aspect of the tibial plafond, and P = 0.005 for articular surface of the medial malleolus). ICRS grades were significantly correlated with clinical outcomes in both groups (all P < 0.05). Mean TAS, TT, and TLS angles improved significantly after SMO in both groups but were not significantly correlated with clinical outcomes or ICRS grade (all n.s.). Conclusions The clinical and second‐look arthroscopic outcomes of MSC injection with marrow stimulation were better compared to those of marrow stimulation alone in patients with varus ankle osteoarthritis who have undergone SMO. Furthermore, the ICRS grade is significantly correlated with clinical outcome.https://doi.org/10.1186/s40634-016-0048-2Mesenchymal stem cellMarrow stimulationSupramalleolar osteotomyVarus ankle osteoarthritis |
| spellingShingle | Yong Sang Kim Moses Lee Yong Gon Koh Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation Journal of Experimental Orthopaedics Mesenchymal stem cell Marrow stimulation Supramalleolar osteotomy Varus ankle osteoarthritis |
| title | Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation |
| title_full | Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation |
| title_fullStr | Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation |
| title_full_unstemmed | Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation |
| title_short | Additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis: short‐term clinical results with second‐look arthroscopic evaluation |
| title_sort | additional mesenchymal stem cell injection improves the outcomes of marrow stimulation combined with supramalleolar osteotomy in varus ankle osteoarthritis short term clinical results with second look arthroscopic evaluation |
| topic | Mesenchymal stem cell Marrow stimulation Supramalleolar osteotomy Varus ankle osteoarthritis |
| url | https://doi.org/10.1186/s40634-016-0048-2 |
| work_keys_str_mv | AT yongsangkim additionalmesenchymalstemcellinjectionimprovestheoutcomesofmarrowstimulationcombinedwithsupramalleolarosteotomyinvarusankleosteoarthritisshorttermclinicalresultswithsecondlookarthroscopicevaluation AT moseslee additionalmesenchymalstemcellinjectionimprovestheoutcomesofmarrowstimulationcombinedwithsupramalleolarosteotomyinvarusankleosteoarthritisshorttermclinicalresultswithsecondlookarthroscopicevaluation AT yonggonkoh additionalmesenchymalstemcellinjectionimprovestheoutcomesofmarrowstimulationcombinedwithsupramalleolarosteotomyinvarusankleosteoarthritisshorttermclinicalresultswithsecondlookarthroscopicevaluation |