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Prospective evaluation of autologous bone marrow-derived mesenchymal stem cell injection in meniscal injury
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DOI：10.4252/wjsc.v18.i3.116298.png)
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Abstract
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BACKGROUND Chronic meniscal injuries pose a significant challenge in orthopedic medicine, frequently resulting in enduring pain, functional limitations, and progression to osteoarthritis. Existing treatment modalities have limitations, particularly for tears in the avascular zone.AIM To evaluate the clinical efficacy of autologous bone marrow-derived mesenchymal stem cell (BM-MSC) injection for treating chronic meniscal injuries. METHODS A prospective clinical trial was conducted between September 2023 and December 2024, enrolling 80 patients with chronic meniscal injuries identified through magnetic resonance imaging (MRI). The patients were administered an intra-articular injection of autologous BM-MSCs (40 & times; 10(6) cells). Primary outcomes included Visual Analog Scale pain, International Knee Documentation Committee and Lysholm Knee scores. Secondary outcomes comprised MRI T2 mapping values and meniscal morphology evaluations. Patients were evaluated at baseline and at 3 months, 6 months, and 12 months after injection. RESULTS Seventy-six patients completed the 12-month follow-up period. Visual Analog Scale pain scores significantly decreased from 6.8 +/- 1.3 at baseline to 2.1 +/- 0.9 at 12 months (P < 0.001). International Knee Documentation Committee scores improved from 42.3 +/- 8.7 to 71.5 +/- 10.2 (P < 0.001), while Lysholm scores improved from 58.4 +/- 11.3 to 85.2 +/- 9.8 (P < 0.001). MRI T2 mapping revealed a significant reduction in T2 relaxation times in the treated meniscus (38.5 +/- 4.2 milliseconds to 31.2 +/- 3.8 milliseconds, P < 0.001), indicating enhanced tissue quality. No serious adverse events were observed. CONCLUSION Autologous BM-MSC injection effectively reduces pain and improves function in patients with chronic meniscal injuries. Moreover, it appears to be a safe alternative to surgery in selected patients.
Keywords:
Bone marrow-derived mesenchymal stem cells
Meniscal injury
Regenerative medicine
Pain relief
Functional recovery
Magnetic resonance imaging T2 mapping
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