1. First Clinical Application of Polyurethane Meniscal Scaffolds with Mesenchymal Stem Cells and Assessment of Cartilage Quality with T2 Mapping at 12 Months.
- Author
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Olivos-Meza A, Pérez Jiménez FJ, Granados-Montiel J, Landa-Solís C, Cortés González S, Jiménez Aroche CA, Valdez Chávez M, Renán León S, Gomez-Garcia R, Martínez-López V, Ortega-Sánchez C, Parra-Cid C, Velasquillo Martinez C, and Ibarra C
- Subjects
- Adolescent, Adult, Female, Humans, Male, Meniscectomy, Meniscus surgery, Middle Aged, Tissue Engineering, Treatment Outcome, Young Adult, Cartilage, Articular surgery, Cartilage, Articular transplantation, Knee Injuries surgery, Mesenchymal Stem Cell Transplantation, Mesenchymal Stem Cells, Osteoarthritis, Knee surgery, Polyurethanes chemistry, Tibial Meniscus Injuries therapy, Tissue Scaffolds
- Abstract
Background: Complex meniscal lesions often require meniscectomy with favorable results in the short term but a high risk of early osteoarthritis subsequently. Partial meniscectomy treated with meniscal substitutes may delay articular cartilage degeneration., Purpose: To evaluate the status of articular cartilage by T2 mapping after meniscal substitution with polyurethane scaffolds enriched with mesenchymal stem cells (MSC) and comparison with acellular scaffolds at 12 months., Methods: Seventeen patients (18-50 years) with past meniscectomies were enrolled in 2 groups: (1) acellular polyurethane scaffold (APS) or (2) polyurethane scaffold enriched with MSC (MPS). Patients in the MPS group received filgrastim to stimulate MSC production, and CD90+ cells were obtained and cultured in the polyurethane scaffold. The scaffolds were implanted arthroscopically into partial meniscus defects. Concomitant injuries (articular cartilage lesions or cartilage lesions) were treated during the same procedure. Changes in the quality of articular cartilage were evaluated with T2 mapping in femur and tibia at 12 months., Results: In tibial T2 mapping, values for the MPS group increased slightly at 9 months but returned to initial values at 12 months ( P > 0.05). In the APS group, a clear decrease from 3 months to 12 months was observed ( P > 0.05). This difference tended to be significantly lower in the APS group compared with the MPS group at the final time point ( P = 0.18). In the femur, a slight increase in the MPS group (47.8 ± 3.4) compared with the APS group (45.3 ± 4.9) was observed ( P > 0.05)., Conclusion: Meniscal substitution with polyurethane scaffold maintains normal T2 mapping values in adjacent cartilage at 12 months. The addition of MSC did not show any advantage in the protection of articular cartilage over acellular scaffolds ( P > 0.05).
- Published
- 2021
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