Track topics on Twitter Track topics that are important to you
Randomized, multicentric, prospective, double-blind study: effectiveness of adding allogenic stem cells to a platelet-poor plasma scaffold after arthroscopic debridement and microfractures in patients with osteochondral lesions of the talus Osteochondral lesions of the talus (LOC), affects the ankle cartilage, which it seems to have less repair capacity than that of other joints such as the knee of the hip. The LOC can be an important source of pain and affects comparatively younger, working age and athletically active patients.
Although there are several therapeutic strategies, debridement and microfractures performed arthroscopically are the most frequent procedures. After this surgery, it is expected that fibrocartilage will form that covers the osteochondral lesion. Though good results have been reported, this fibrocartilage presents histological characteristics of lower quality to those of the native articular cartilage.
Based on previous studies in different joints, it is hypothesized that the augmentation treatment of osteochondral lesions of the talus with mesenchymal allogeneic stromal cells derived from the umbilical cord produces better clinical and imaging results than standard treatment with debridement and microfractures only.
Therefore, the present study seeks to compare the effectiveness of traditional debridement and microfracture treatment versus adding a platelet-poor plasma (PPP) scaffold embedded in allogeneic mesenchymal stromal cells derived from the umbilical cord in patients with osteochondral lesions of the talus.
As with other major joints of the lower limb that carry weight (hip, knee), the osteochondral lesion (LOC) of the talus, can be a major source of pain and disability for the affected patient. The LOC of the talus can appear after one (or repeated) traumatic injury, compromises the bone and adjacent cartilage, being able to cause blisters in the cartilage layers, lesions similar to a cyst within the bone under the cartilage, or fracture of the cartilage and the bony layers.
The ankle joint supports multiple loads of the corporal weight in the daily activities, the reason why the properties of the cartilage in the ankle are different from those that appear in the hip and the knee. In the absence of an injury, the cartilage of the ankle has better resistance and tension properties to face the increase of forces than the hip or knee throughout life.
However, once an injury appears, the cartilage of the ankle appears to have less repair capacity compared to the hip or knee. Since the most common cause of LOC of the talus is post-traumatic, the average age of these patients is comparatively lower than that of patients affected by injuries to other joints.
Osteochondral injuries have an incidence of 27 per 10,0000 inhabitants in the USA. They are injuries that usually affect the working population and active sportsperson, producing pain, functional limitation and that probably contribute towards the evolution of an accelerated joint degeneration. Currently, there are multiple treatment modalities used by ankle and foot surgeons. These include debridement and microfractures of the subchondral plaque, utilization of totipotential cells, osteochondral autograft/allograft, tibiotalar arthrodesis, and partial/total ankle arthroplasty. However, no treatment offers a clear superiority over the others.
Debridement and microfractures performed arthroscopically is the most frequently used procedure and involves; the removal of degenerated cartilage and subchondral bone; obtaining firm lesional edges that prevent the spread of the lesion; and finally the stimulation of the bone marrow talar by performing microfractures of the subchondral plate. This with the hope that fibrocartilage will form that covers the osteochondral lesion. Although this fibrocartilage has histological characteristics different from those of native articular cartilage, good results have been reported in 82% of the cases when combining good quality studies in this regard.
The standard technique is not able to generate a replacement articular cartilage strong enough to support the joint loads to which the ankle is exposed. Therefore, clinical trials seek to increase the traditional treatment of debridement and microfractures with the intra-articular use of totipotent cells at the end of the procedure. Although the results of these series are promising and comparable at least to those of traditional treatment, the absence of comparative studies between them complicates the choice of treatment for both the patient and the surgeon. For this reason, the investigators have designed a prospective, comparative, double-blind study that will allow elucidating which of these interventions is the best alternative for our patients.
To compare the effectiveness of traditional debridement and microfracture treatment versus adding a platelet-poor plasma (PPP) scaffold embedded in allogenic stromal mesenchymal cells derived from the umbilical cord in patients with osteochondral lesions of the talus.
- To compare functional and radiological results before versus post-surgery within each group studied (control and experimental)
- To compare functional results after surgery of the groups in traditional treatment versus traditional treatment plus mesenchymal stromal cells (MSC).
- To compare the quality of repair of the tissues of the groups in traditional treatment versus traditional treatment plus mesenchymal stromal cells (MSC).
The augmentation treatment of the osteochondral lesions of the talus with mesenchymal cells produces better clinical and imaging results than standard treatment with only debridement and microfractures.
Osteochondral Fracture of Talus
Allogenic stromal mesenchymal cells derived from the umbilical cord, Debridement and microfracture
Universidad de Chile Clinical Hospital
University of Chile
Published on BioPortfolio: 2019-04-11T11:54:50-0400
This study aims at expanding Umbilical Cord derived Mesenchymal Stem Cells (MSCs) to a clinical scale according to Good Laboratory Practice and study its efficacy when compared to a Superv...
Cerebral palsy(CP) consisted of a group of developmental disability in the field of motor function and is one of the major problems of pediatric neurology and at the present time there is ...
Knee-osteoarthritis (OA) is a common and disabling problem, that represents a global health issue since none of the current therapies are truly disease modifying. The use of mesenchymal st...
The purpose of this study is to evaluate the safety and efficacy of intrathecal administration of allogeneic umbilical cord derived mesenchymal stem cells to patients with spinal cord inju...
Primary Objective: To evaluate the safety and efficacy of human umbilical cord-derived mesenchymal stem cells（hUC-MSCs） to treat refractory immune thrombocytopenia（ITP）. Secondary...
Mesenchymal Stem/ Stromal Cells assume a supporting role to the intrinsic mechanisms of tissue regeneration, a feature mostly assigned to the contents of their secretome. A comparative study on the me...
Mesenchymal stromal cells (MSCs) hold broad therapeutic potential in various diseases, however, it is difficult to produce sufficient numbers of MSCs for clinical application, therefore, improved cult...
Although much progress has been made in the treatment of gliomas, the prognosis for patients with gliomas is still very poor. Stem cell-based therapies may be promising options for glioma treatment. R...
Mesenchymal stem cells (MSCs) hold great therapeutic potential in morbidities associated with preterm birth. However, the molecular expressions of hMSCs in preterm birth infants have not been systemat...
The aim of this study was to investigate the molecular mechanism of human umbilical cord mesenchymal stem cells (MSCs)-derived exosomes (hUCMSC-Exos) in regulating burn-induced acute lung injury (ALI)...
Bone-marrow-derived, non-hematopoietic cells that support HEMATOPOETIC STEM CELLS. They have also been isolated from other organs and tissues such as UMBILICAL CORD BLOOD, umbilical vein subendothelium, and WHARTON JELLY. These cells are considered to be a source of multipotent stem cells because they include subpopulations of mesenchymal stem cells.
Jelly-like connective tissue of the UMBILICAL CORD that contains MESENCHYMAL STROMAL CELLS.
Neoplasms derived from the primitive sex cord or gonadal stromal cells of the embryonic GONADS. They are classified by their presumed histogenesis and differentiation. From the sex cord, there are SERTOLI CELL TUMOR and GRANULOSA CELL TUMOR; from the gonadal stroma, LEYDIG CELL TUMOR and THECOMA. These tumors may be identified in either the OVARY or the TESTIS.
Endothelial cells that line venous vessels of the UMBILICAL CORD.
Neoplasms of the endometrial stroma that sometimes involve the MYOMETRIUM. These tumors contain cells that may closely or remotely resemble the normal stromal cells. Endometrial stromal neoplasms are divided into three categories: (1) benign stromal nodules; (2) low-grade stromal sarcoma, or endolymphatic stromal myosis; and (3) malignant endometrial stromal sarcoma (SARCOMA, ENDOMETRIAL STROMAL).
Track and monitor developments in stem cell research and commercial development. Follow the tabs above to read the latest global news, research, clinical trials on stem cells and follow companies active in the stem cell industry. BioPort...
Blood is a specialized bodily fluid that delivers necessary substances to the body's cells (in animals) – such as nutrients and oxygen – and transports waste products away from those same cells. In vertebrates, it is composed of blo...
A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint causes pain, stiffness, and swelling with ...