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Cartilage Lesions and Osteoarthritis: Cell Therapy

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Orthobiologics

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Abstract

Symptomatic cartilage lesions and early osteoarthritis (OA) are musculoskeletal issues with both significant clinical and large economic burdens. Despite regenerative techniques, such as the use of autologous chondrocytes, the complete healing of damaged cartilage with consistent reproduction of normal hyaline cartilage has not yet been achieved. Alternatively, mesenchymal stromal cells (MSC) have received considerable research attention as a cellular therapy injective option. MSC populations are the product of competitive expansion and clone selection starting from a mixed population of heterogeneous tissue-specific colony connective progenitors (CTPs). While MSC populations vary significantly from batch to batch and patient to patient, culture-expanded MSCs are relatively easy to generate and are capable of chondrogenic differentiation potential. Intra-articular (IA) injection of MSCs can be an efficient and minimally invasive delivery system. The results of preclinical studies have provided preliminary evidence of safety and efficacy of MSCs for the treatment of OA. Several clinical trials have demonstrated that IA injection of MSCs has beneficial outcomes for patients with OA. The use of concentrates, mainly from bone marrow and adipose tissue, is recently growing to take advantage of MSC potential while avoiding the complexity related to cell expansion. In this chapter, we discuss the feasibility of IA injection of MSCs and concentrates, and the current evidence on the clinical efficacy as a potential therapy for patients with cartilage lesions and OA.

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Authors and Affiliations

  1. Sports Medicine Division, Department of Orthopaedic Surgery, University of São Paulo Medical School, São Paulo, Brazil

    Tiago Lazzaretti Fernandes

  2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Kazunori Shimomura & Norimasa Nakamura

  3. McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada

    David A. Hart

  4. Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Angelo Boffa

  5. Institute for Medical Science in Sports, Osaka Health Science University, 1-9-27, Tenma, Kita-ku, Osaka, Japan

    Norimasa Nakamura

  6. Global Centre for Medical Engineering and Informatics, Osaka University, Osaka, Japan

    Norimasa Nakamura

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  1. Tiago Lazzaretti Fernandes
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  2. Kazunori Shimomura
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  3. David A. Hart
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  4. Angelo Boffa
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  5. Norimasa Nakamura
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Correspondence to Norimasa Nakamura .

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  1. Rizzoli Orthopaedic Institute, Bologna, Italy

    Giuseppe Filardo

  2. Orthopaedic & Sports Medicine Group, Santa Monica Orthopaedic & Sports Medicine, Santa Monica, CA, USA

    Bert R. Mandelbaum

  3. Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA

    George F. Muschler

  4. Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  5. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

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Fernandes, T.L., Shimomura, K., Hart, D.A., Boffa, A., Nakamura, N. (2022). Cartilage Lesions and Osteoarthritis: Cell Therapy. In: Filardo, G., Mandelbaum, B.R., Muschler, G.F., Rodeo, S.A., Nakamura, N. (eds) Orthobiologics. Springer, Cham. https://doi.org/10.1007/978-3-030-84744-9_25

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  • DOI: https://doi.org/10.1007/978-3-030-84744-9_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84743-2

  • Online ISBN: 978-3-030-84744-9

  • eBook Packages: MedicineMedicine (R0)

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