Revista Médica de Risaralda

Dosis de células madre en el tratamiento de osteoartritis de rodilla

Samuel Eduardo Trujillo Henao, Julieta Henao Bonilla, Gustavo Adolfo Marín S., Camila Vargas M., Jainer Aranzazu, Bibiana Murillo G, Camilo Marín G


Osteoarthritis (OA) is a degenerative disease where conventional treatment includes drugs, physiotherapy, or prostheses. Stem cells and growth factors are a promising option in controlling symptoms, functional improvement and cartilage regeneration; however, many treatment details have not been specified, such as type and number of stem cells that should be applied to obtain optimal results. In this study we sought to compare effectiveness, safety and costs of two doses (1X107vs 3X107) of adipose tissue derived stem cells (ADSC), applied intra-articularly.
Ten patients, with knee OA grades II and III, were randomized to receive 10 (n=5) or 30 million (n=5) of autologous ADSCs. At baseline and 6 to 10 months after injection, they were evaluated according to clinical (medical evaluation, WOMAC scale, quality of life) and paraclinical criteria (arthroscopy, resonance, biopsy).
In terms of effectiveness and safety there were no differences observed among the two dosage groups since all patients had improvement according to medical criteria and the WOMAC scale (P=0,001); in the arthroscopic control, 7 patients had "good/very good" response, 1 "neutral" and 2 forwent control; biopsies confirm joint regeneration, although there were no differences in the before and after magnetic resonances.
In knee osteoarthritis, the application of 10 or 30 million ADSCs was equally effective and safe; however, the protocol with 10 million cells does not require in vitro expansion, requires less time, is simpler and has a lower cost. This study shows good reason to undertake randomized clinical trials to gain higher quality evidence.

Palabras clave

growth factors, osteoarthritis, quality of life, regenerative medicine, stem cells.

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