Transplante autólogo de células mononucleares da medula óssea no tratamento de osteoartrite do joelho

Abstract

INTRODUCTION: osteoarthritis is the most common joint disease worldwide. New evidence demonstrates the important role played by the subchondral bone in the development of this pa-thology. However, the available treatments only produce symptom control and do not address the pathological subchondral bone. OBJECTIVES: To evaluate the safety of autologous sub-chondral autologous bone marrow mononuclear cell transplantation (BMMC) and its efficacy in the treatment of patients with early grades of knee osteoarthritis. METHODS: 13 patients were selected and underwent treatment with autologous subchondral BMMC knee transplantation. Patients were evaluated according to the Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities OA Index (WOMAC), SF-36 quality of life questionnaire and the Visual Analogue Scale (VAS) for pain. Changes in articular cartilage were evaluated using magnetic resonance imaging. RESULTS: Outcome analysis showed an improvement in pain reduction of 17.7 ± 22.2 points twelve months after treatment (𝑝 = 0.014). There was also an improvement in all other areas of KOOS as well as WOMAC. Improvement in pain VAS, related to daily activity, was detected in the third week after the procedure, which lasted until the end of the study period. Ten (76.9%) patients maintained the same radiological appearance of the lesion 12 months after the procedure. CONCLUSION: it was concluded that the subchondral BMMC autologous transplant technique developed in this study is safe, providing significant improvements in pain parameters, functional capacity and quality of life in short-term evaluation. This technique could be a new treatment modality for early-stage osteoar-thritis.