Treatment of Knee Osteoarthritis With Autologous Mesenchymal Stem Cells: A Pilot Study Intra-articular injections of expanded mesenchymal stem cells with and without addition of platelet-rich plasma are safe and effective for knee osteoarthritis Adipose Mesenchymal Stromal Cell-Based Therapy for Severe Osteoarthritis of the Knee: A Phase I Dose-Escalation Trial. Treatment of Knee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells: A Randomized Controlled Trial A randomized controlled clinical and radiological trial about outcomes of navigation-assisted TKA compared to conventional TKA: long-term follow-up Adipose Derived Stromal Cell (ADSC) Injections for Pain Management of Osteoarthritis in the Human Knee Joint. Intra-articular injection of two different doses of autologous bone marrow mesenchymal stem cells versus hyaluronic acid in the treatment of knee osteoarthritis: multicenter randomized controlled clinical trial (phase I/II) Intra-articular Injection of Mesenchymal Stem Cells and Platelet-Rich Plasma to Treat Patellofemoral Osteoarthritis: Preliminary Results of a Long-Term Pilot Study. The effect of intra‐articular injection of autologous bone marrow stem cells on pain and knee function in patients with osteoarthritis Matrix-induced autologous mesenchymal stem cell implantation versus matrix-induced autologous chondrocyte implantation in the treatment of chondral defects of the knee: a 2-year randomized study Final results of a phase I-II trial using ex vivo expanded autologous Mesenchymal Stromal Cells for the treatment of osteoarthritis of the knee confirming safety and suggesting cartilage regeneration. Intra-articular injection of expanded autologous bone marrow mesenchymal cells in moderate and severe knee osteoarthritis is safe: a phase I/II study Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35–54 years with chronic knee pain Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow‐up of three patients Intra‐articular injection of autologous adipose‐derived mesenchymal stem cells in the treatment of knee osteoarthritis Effects of triamcinolone acetonide on an in vivo equine osteochondral fragment exercise model.
Background Osteoarthritis is the most prevalent joint disease and a frequent cause of joint pain , functional loss , and disability . Osteoarthritis often becomes chronic , and conventional treatments have demonstrated only modest clinical benefits without lesion reversal . Cell-based therapies have shown encouraging results in both animal studies and a few human case reports . We design ed a pilot study to assess the feasibility and safety of osteoarthritis treatment with mesenchymal stromal cells ( MSCs ) in humans and to obtain early efficacy information for this treatment . Methods Twelve patients with chronic knee pain unresponsive to conservative treatments and radiologic evidence of osteoarthritis were treated with autologous exp and ed bone marrow MSCs by intra-articular injection ( 40 × 106 cells ) . Clinical outcomes were followed for 1 year and included evaluations of pain , disability , and quality of life . Articular cartilage quality was assessed by quantitative magnetic resonance imaging T2 mapping . Results Feasibility and safety were confirmed , and strong indications of clinical efficacy were identified . Patients exhibited rapid and progressive improvement of algofunctional indices that approached 65 % to 78 % by 1 year . This outcome compares favorably with the results of conventional treatments . Additionally , quantification of cartilage quality by T2 relaxation measurements demonstrated a highly significant decrease of poor cartilage areas ( on average , 27 % ) , with improvement of cartilage quality in 11 of the 12 patients . Conclusions MSC therapy may be a valid alternative treatment for  chronic knee osteoarthritis . The intervention is simple , does not require hospitalization or surgery , provides pain relief , and significantly improves cartilage quality Purpose To compare the effectiveness and safety of intra-articular injections of autologous exp and ed mesenchymal stromal stem cells alone ( MSCs ) , or in combination with platelet-rich plasma ( MSCs + PRP ) , in patients with knee osteoarthritis . Methods Eighteen patients ( 57.6 ± 9.6 years ) with radiographic symptomatic knee osteoarthritis ( Dejour grade s II – IV ) were r and omized to receive intra-articular injections of MSCs ( n = 9 ) or MSCs + PRP ( n = 9 ) . Injections were performed 2–3 weeks after bone marrow aspiration ( ± 80–100 ml ) which was obtained from both posterior iliac crests . Results The Knee Injury and Osteoarthritis Outcome Score ( KOOS ) improved significantly throughout the 12 months for both groups ( p < 0.05 ) . No statistically significant differences between groups were found in KOOS subscales and global score improvements at 12-month end-point ( n.s . ) . The MSCs group showed significant improvements in the pain , function and daily living activities , and sports and recreational activities subscales ( p < 0.05 ) . Similarly , the MSCs + PRP group showed significant improvements in the pain , function and daily living activities and quality of life subscales ( p < 0.05 ) . The average number of fibroblast colony forming units ( CFU-F ) was 56.8 + 21.9 for MSCs group and 50.7 ± 21.7 for MSCs + PRP group . Minimal adverse effects were seen in both groups ( 10 adverse events , in 5 patients ) . Conclusions Intra-articular injections of exp and ed MSCs alone or in combination with PRP are safe and have a beneficial effect on symptoms in patients with symptomatic knee osteoarthritis . Adding PRP to the MSCs injections did not provide additional benefit . These results are encouraging and support the recommendation of this minimally invasive procedure in patients with knee osteoarthritis , without requiring hospitalization . The CFU-F results may be used as reference for future research .Level of evidence Prospect i ve cohort study , Level II UNLABELLED : Osteoarthritis ( OA ) is the most widespread musculoskeletal disorder in adults . It leads to cartilage damage associated with subchondral bone changes and synovial inflammation , causing pain and disability . The present study aim ed at evaluating the safety of a dose-escalation protocol of intra-articular injected adipose-derived stromal cells ( ASCs ) in patients with knee OA , as well as clinical efficacy as secondary endpoint . A bicentric , uncontrolled , open phase I clinical trial was conducted in France and Germany with regulatory agency approval for ASC expansion procedure in both countries . From April 2012 to December 2013 , 18 consecutive patients with symptomatic and severe knee OA were treated with a single intra-articular injection of autologous ASCs . The study design consisted of three consecutive cohorts ( six patients each ) with dose escalation : low dose ( 2 × 10(6 ) cells ) , medium dose ( 10 × 10(6 ) ) , and high dose ( 50 × 10(6 ) ) . The primary outcome parameter was safety evaluated by recording adverse events throughout the trial , and secondary parameters were pain and function subscales of the Western Ontario and McMaster Universities Arthritis Index . After 6 months of follow-up , the procedure was found to be safe , and no serious adverse events were reported . Four patients experienced transient knee joint pain and swelling after local injection . Interestingly , patients treated with low-dose ASCs experienced significant improvements in pain levels and function compared with baseline . Our data suggest that the intra-articular injection of ASCs is a safe therapeutic alternative to treat severe knee OA patients . A placebo-controlled double-blind phase IIb study is being initiated to assess clinical and structural efficacy . SIGNIFICANCE Although this phase I study included a limited number of patients without a placebo arm , it showed that local injection of autologous adipose-derived stem cells was safe and well tolerated in patients with knee osteoarthritis . This study also provides encouraging preliminary evidence of efficacy . Larger and controlled long-term studies are now m and atory to confirm whether this new strategy of cell therapy can improve pain and induce structural benefit in osteoarthritis Background Osteoarthritis is the most prevalent joint disease and a common cause of joint pain , functional loss , and disability . Conventional treatments demonstrate only modest clinical benefits without lesion reversal . Autologous mesenchymal stromal cell ( MSC ) treatments have shown feasibility , safety , and strong indications for clinical efficacy . We performed a r and omized , active control trial to assess the feasibility and safety of treating osteoarthritis with allogeneic MSCs , and we obtain information regarding the efficacy of this treatment . Methods We r and omized 30 patients with chronic knee pain unresponsive to conservative treatments and showing radiological evidence of osteoarthritis into 2 groups of 15 patients . The test group was treated with allogeneic bone marrow MSCs by intra-articular injection of 40 × 106 cells . The control group received intra-articular hyaluronic acid ( 60 mg , single dose ) . Clinical outcomes were followed for 1 year and included evaluations of pain , disability , and quality of life . Articular cartilage quality was assessed by quantitative magnetic resonance imaging T2 mapping . Results Feasibility and safety were confirmed and indications of clinical efficacy were identified . The MSC-treated patients displayed significant improvement in algofunctional indices versus the active controls treated with hyaluronic acid . Quantification of cartilage quality by T2 relaxation measurements showed a significant decrease in poor cartilage areas , with cartilage quality improvements in MSC-treated patients . Conclusions Allogeneic MSC therapy may be a valid alternative for the treatment of  chronic knee osteoarthritis  that is more logistically convenient than autologous MSC treatment . The intervention is simple , does not require surgery , provides pain relief , and significantly improves cartilage quality Abstract Purpose Well balanced knees with good alignment are essential for a well-functioning TKA with long survival of its implants . This prospect i ve r and omized study comparing navigation-assisted TKA and conventional TKA reported the clinical and radiological outcomes at a follow-up of 9 years . The purpose of this study was to compare the clinical and radiological outcomes for patients who underwent navigation-assisted TKA or conventional TKA after long-term follow-up . Methods A total of 80 patients ( 88 knees ) were available for physical and radiological examination 9 years after TKA . Clinical outcomes were evaluated using HSS , WOMAC , and KS function and pain scores . And radiological outcomes of the component loosening and its survivorship during 9-year follow-up were also evaluated . Results There were no significant differences in the field of clinical outcomes between the two groups . In terms of radiological outcomes , the navigation group had fewer alignment outliers ( 7.3 vs 20 % , p = 0.006 ) . Although the clinical outcomes showed no differences between the two groups , the survival rate was slightly better in the navigation group than in the conventional group without statistical significance ( best-case scenario 100 vs 95.3 % , n.s . , worst-case scenario 95.6 vs 88.4 % , n.s . ) . Conclusion Navigation-assisted TKA produced better alignment outcomes and better survival rates than conventional instruments although some of the differences were not statistically significant . Level of evidence BACKGROUND This safety and feasibility study used autologous adipose-derived stromal vascular cells ( the stromal vascular fraction [ SVF ] of adipose tissue ) , to treat 8 osteoarthritic knees in 6 patients of grade I to III ( K-L scale ) with initial pain of 4 or greater on a 10-point Visual Analog Scale ( VAS ) . OBJECTIVES The primary objective of the study was evaluation of the safety of intra-articular injection of SVF .  The secondary objective was to assess initial feasibility for reduction of pain in osteoarthritic knees . METHODS Adipose-derived SVF cells were obtained through enzymatic disaggregation of lipoaspirate , resuspension in 3 mL of Lactated Ringer 's Solution , and injection directly into the intra-articular space of the knee , with a mean of 14.1 million viable , nucleated SVF cells per knee . Metrics included monitoring of adverse events and preoperative to postoperative changes in the Western Ontario and McMaster Universities Arthritis Index ( WOMAC ) , the VAS pain scale , range of motion ( ROM ) , timed up- and -go ( TUG ) , and MRI . RESULTS No infections , acute pain flares , or other adverse events were reported . At 3-months postoperative , there was a statistically significant improvement in WOMAC and VAS scores ( P < .02 and P < .001 , respectively ) , which was maintained at 1 year . Physical therapy measurements for ROM and TUG both improved from preoperative to 3-months postoperative . St and ard MRI assessment from preoperative to 3-months postoperative showed no detectable structural differences . All patients attained full activity with decreased knee pain . CONCLUSIONS Autologous SVF was shown to be safe and to present a new potential therapy for reduction of pain for osteoarthritis of the knee . LEVEL OF EVIDENCE 4 : Therapeutic Abstract Background Mesenchymal stromal cells are a promising option to treat  knee osteoarthritis . Their safety and usefulness must be confirmed and the optimal dose established . We tested increasing doses of bone marrow mesenchymal stromal cells ( BM-MSCs ) in combination with hyaluronic acid in a r and omized clinical trial . Material sA phase I/II multicenter r and omized clinical trial with active control was conducted . Thirty patients diagnosed with knee OA were r and omly assigned to intraarticularly administered hyaluronic acid alone ( control ) , or together with 10 × 106 or 100 × 106 cultured autologous BM-MSCs , and followed up for 12 months . Pain and function were assessed using VAS and WOMAC and by measuring the knee motion range . X-ray and magnetic resonance imaging analyses were performed to analyze joint damage . Results No adverse effects were reported after BM-MSC administration or during follow-up . BM-MSC-administered patients improved according to VAS during all follow-up evaluations and median value ( IQR ) for control , low-dose and high-dose groups change from 5 ( 3 , 7 ) , 7 ( 5 , 8) and 6 ( 4 , 8) to 4 ( 3 , 5 ) , 2 ( 1 , 3 ) and 2 ( 0,4 ) respectively at 12 months ( low-dose vs control group p = 0.005 and high-dose vs control group p < 0.009 ) . BM-MSC-administered patients were also superior according to WOMAC , although improvement in control and low-dose patients could not be significantly sustained beyond 6 months . On the other h and , the BM-MSC high-dose group exhibited an improvement of 16.5 ( 12 , 19 ) points at 12 months ( p < 0.01 ) . Consistent with WOMAC and VAS values , motion ranges remained unaltered in the control group but improved at 12 months with BM-MSCs . X-ray revealed a reduction of the knee joint space width in the control group that was not seen in BM-MSCs high-dose group . MRI ( WORMS protocol ) showed that joint damage decreased only in the BM-MSC high-dose group , albeit slightly . Conclusions The single intraarticular injection of in vitro exp and ed autologous BM-MSCs together with HA is a safe and feasible procedure that results in a clinical and functional improvement of knee OA , especially when 100 × 106 cells are administered . These results pave the way for a future phase III clinical trial . Clinical Trials.gov identifier NCT02123368 . Nº EudraCT : 2009 - 017624 - PURPOSE To assess the feasibility and safety of concomitant intra-articular ( IA ) knee injection of mesenchymal stem cells ( MSCs ) and platelet-rich plasma ( PRP ) under fluoroscopic guidance to treat patellofemoral osteoarthritis ( OA ) . MATERIAL S AND METHODS This prospect i ve study included 19 consecutive patients referred for fluoroscopically guided IA MSC and PRP injection for symptomatic patellofemoral chondropathy in which conservative treatment had failed .  Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) score and magnetic resonance ( MR ) data , including T2 mapping sequence , were prospect ively collected before and 6 months after treatment . Clinical data without MR imaging were collected until 12 months after the procedure . RESULTS WOMAC scores were significantly lower after IA injection of MSCs and PRP at 6 months and during 12-months follow-up compared with baseline ( mean score decreased from 34.3 to 14.2 ; P < .0018 ) . Patients reported no complications . Concerning MR imaging follow-up , there were no significant differences in grade , surface , or T2 value of the chondral lesions ( P > .375 ) . CONCLUSIONS IA injection of MSCs and PRP in early patellofemoral OA appears to allow functional improvement Management of osteoarthritis ( OA ) is basically symptomatic . Recently , stem cells ( SC ) have been used in the search for an optimum treatment . We decided to conduct a controlled clinical trial to determine if a single intra‐articular injection of in vivo stimulated bone marrow SC could lead to an improvement in pain management and quality of life in patients with knee OA Abstract Background Cell-based strategies that combine in vitro- exp and ed autologous chondrocytes with matrix scaffolds are currently preferred for full-thickness cartilage lesions of the knee ≥2 cm2 . Although this approach is reasonable , continuing advances in the field of cartilage repair will further exp and the options available to improve outcomes .Hypothesis/ purpose In the present clinical study , we compared the outcomes of matrix-induced autologous mesenchymal stem cell implantation ( m-AMI ) with matrix-induced autologous chondrocyte implantation ( m-ACI ) for the treatment of isolated chondral defects of the knee . Study design Prospect i ve , single-site , r and omized , single-blind pilot study . Methods Fourteen patients with isolated full-thickness chondral lesions of the knee > 2 cm2 were r and omized into two treatment groups : m-AMI and m-ACI . Outcomes were assessed pre-operatively and 3 , 6 , 12 and 24 months post-operatively . Results Clinical evaluations revealed that improvement from pre-operation to 24 months post-operation occurred in both groups ( p < 0.05 ) . At all follow-up intervals , m-AMI demonstrated significantly better functional outcomes ( motion deficit and straight leg raise strength ) than did m-ACI ( p < 0.05 ) . At all follow-up intervals , m-AMI demonstrated significantly better subjective sub-scale scores for pain , symptoms , activities of daily living and sport and recreation of the knee injury and osteoarthritis outcome score ( KOOS ) than did m-ACI ( p < 0.05 ) . Additionally , m-AMI demonstrated significantly better ( p < 0.05 ) scores than m-ACI for the quality of life sub-scale of the KOOS and visual analog scale ( VAS ) severity at the 6-month follow-up . The Tegner activity score and VAS frequency were not significantly different between the two groups . Graft failure was not observed on magnetic resonance imaging at the 24-month follow-up . m-AMI and m-ACI demonstrated very good-to-excellent and good-to-very good infill , respectively , with no adverse effects from the implant , regardless of the treatment . Conclusion For the treatment of isolated full-thickness chondral lesion of the knee , m-AMI can be used effectively and may potentially accelerate recovery . A larger patient cohort and follow-up supported by histological analyses are necessary to determine long-term outcomes BACKGROUND Cellular therapies have shown encouraging results in the treatment of chronic osteoarthritis ( OA ) . Herein , we present the final results of a phase I-II clinical trial assessing the feasibility , safety and efficacy of ex vivo exp and ed autologous bone marrow Mesenchymal Stromal Cells ( MSC , XCEL-M-ALPHA ) , infused intra-articularly , in patients with knee OA . METHODS Fifteen patients ( median age=52years ) with grade II(9 ) or III(6 ) gonarthrosis ( Kellgren & Lawrence classification ) and chronic pain were treated with an intra-articular infusion of 40.9 × 10(6)±0.4 × 10(6 ) MSCin a phase I-II prospect i ve , open-label , single-dose , single-arm clinical trial . Endpoints were safety and tolerability . Efficacy was measured by the Visual Analogue Scale for pain , algofunctional Health Assessment Question naire , Quality of Life ( QoL ) SF-36 question naire , Lequesne functional index and WOMAC score . Cartilage integrity was assessed by Magnetic Resonance Imaging and quantitative T2-mapping at 0 , 6 and 12months . RESULTS The cell-based product was well tolerated with few reported Adverse Events ( mild arthralgia and low back pain ) . There was a relevant decrease in the intensity of pain since day 8 after the infusion , that was maintained after 12months . The SF-36 QoL test showed improvement of parameters including bodily pain , role physical and physical functioning at month 12 . The health assessment question naire revealed a significant decrease of incapacity . Moreover , T2 mapping showed signs of cartilage regeneration in all patients at 12months post-treatment . CONCLUSIONS Single intra-articular infusion of XCEL-M-ALPHA is a safe and well-tolerated cell-based product , associated with a long-lasting amelioration of pain , improvement of QoL ( up to four years ) , and signs of cartilage repair Background Knee osteoarthritis ( KOA ) is a major health problem especially in the aging population . There is a need for safe treatment that restores the cartilage and reduces the symptoms . The use of stem cells is emerging as a possible option for the moderate and severe cases . This study aim ed at testing the safety of autologous bone marrow mesenchymal stem cells ( BM-MSCs ) exp and ed in vitro when given intra-articularly to patients with stage II and III KOA . As a secondary end point , the study tested the ability of these cells to relieve symptoms and restore the knee cartilage in these patients as judged by normalized knee injury and Osteoarthritis Outcome Score ( KOOS ) and by magnetic resonance imaging ( MRI ) . Methods Thirteen patients with a mean age of 50 years suffering from KOA stages II and III were given two doses of BM-MSCs 1 month apart totaling 61 × 106 ± 0.6 × 106 by intra-articular injection in a phase I prospect i ve clinical trial . Each patient was followed for a minimum of 24 months for any adverse events and for clinical outcome using normalized KOOS . Cartilage thickness was assessed by quantitative MRI T2 at 12 months of follow-up . Results No severe adverse events were reported up to 24 months follow-up . Normalized KOOS improved significantly . Mean knee cartilage thickness measured by MRI improved significantly . Conclusion BM-MSCs given intra-articularly are safe in knee osteoarthrosis . Despite the limited number of patients in this study , the procedure described significantly improved the KOOS and knee cartilage thickness , indicating that they may enhance the functional outcome as well as the structural component . Trial registration Clinical Trials.gov , OBJECTIVES To determine the prevalence of tibiofemoral radiographic knee osteoarthritis ( OA ) in people aged 35–54 years associated with chronic ( > 3 months ) knee pain  using two different radiographic grading systems . METHODS Population based postal survey in a r and om sample of inhabitants in a district in southern Sweden followed by  clinical examination and plain posteroanterior , weight bearing radiographical examination .  The Ahlbäck criteria ( focusing on joint space narrowing ) and the Kell- gren & Lawrence classification for knee OA were used for diagnosing tibiofemoral OA . RESULTS A question naire was sent to 2000 r and omly selected people aged 35–54 years . The response rate was 92.6 % . Fifteen per cent of these people reported chronic knee pain .  This group ( n=279 ) was offered a clinical and radiographic examination of the knee joint and 204 persons agreed to participate . According to the Kellgren & Lawrence classification 28 subjects had OA of the knee grade 2 or more and 16 grade 3 or more . Radiographically detected OA of the knee according to Ahlbäck was found in 20 cases . The minimum prevalence of radiological tibiofemoral knee OA with knee pain was thus 1.5 % for Kellgren & Lawrence grade 2 or more , 0.9 % for grade 3 or more , and 1.1 % according to the Ahlbäck classification . The agreement between the Kellgren & Lawrence grade s 2–3 versus Ahlbäck grade I as well as grade 3–4 versus Ahlbäck grade I – II was good ( κ 0.76 and 0.78 respectively ) . CONCLUSION The prevalence of radiographic tibiofemoral OA combined with  chronic knee pain in people aged 35–54 years was around 1 % as estimated by either the Kellgren & Lawrence or the Ahlbäck classifications systems . Prospect i ve follow up of this cohort should eluci date the significance of knee pain as a sign of developing OA Osteoarthritis is a degenerative joint disease characterized by the destruction of joint cartilage . Mesenchymal stem cells ( MSCs ) are found in low numbers in normal cartilage , mainly in the superficial layer , acting as repairing agents . In OA , MSCs are seen in larger numbers , but act chaotic and are unable to repair the cartilage . The synovial membrane becomes inflamed and interacts with the cartilage . Transplanted MSC have the ability to normalize them , redirecting them to their normal function . In a preliminary study , we showed that MSC could improve knee OA in four patients at 6 months . This report shows their long‐term follow‐up at 5 years BACKGROUND Osteoarthritis ( OA ) is a chronic degenerative joint disease and is considered to be the fourth leading cause of disability and the second cause of inability to work in men . Recently , adipose-derived mesenchymal stem cells ( AD-MSCs ) came into focus for regenerative medicine as a promising tool for the treatment of OA . The administration of stem cells into impaired joints results in pain relief and improves quality of life , accompanied by restoration of hyaline articular cartilage . METHODS In the present study , nine patients ( including two patients with bilateral symptoms ) diagnosed with osteoarthritis ( International Knee Documentation grade B in 5 and grade D in six knees ) were treated using a single injection of AD-MSCs at a concentration of 0.5 - 1.0 × 107 cells and were followed up for 18 months . During follow-up , all the cases were evaluated clinical ly by Knee Society score ( KSS ) , Hospital for Special Surgery knee score ( HSS-KS ) , Tegner-Lysholm ( T-L ) score and visual analogue scale ( VAS ) of pain , as well as by plain radiography and by magnetic resonance imaging visualization with 2D Magnetic Resonance Observation of Cartilage Repair Tissue ( MOCART ) score assessment . RESULTS Significant improvement of all four clinical scores was observed within the first 6 months ( KSS for 41.4 points , HSS-KS for 33.9 points , T-L score for 44.8 points , VAS of pain from 54.5 to 9.3 ) and improvement persisted throughout the rest of the follow-up . MOCART score showed significant cartilage restoration ( from 43 ± 7.2 to 63 ± 17.1 ) , whereas radiography showed neither improvement , nor further joint degeneration . CONCLUSIONS The results obtained in the present study provide good basis for prospect i ve r and omized controlled clinical trials with respect to the use of AD-MSCs in the treatment of osteoarthritis The objective of this study was to determine the effects of intra-articularly administered triamcinolone acetonide ( TA ) in exercised equine athletes with carpal osteochondral fragmentation . Eighteen horses were r and omly assigned to each of 3 groups . An osteochondral chip fragment was created in one r and omly chosen intercarpal joint of each horse . Both intercarpal joints in the placebo control group ( CNT ) horses were injected with intra-articular administration ( IA ) of polyionic fluid . Both joints in the TA control group ( TA CNT ) horses were treated with 12 mg of TA in the intercarpal joint without an osteochondral fragment , and the opposite intercarpal joint was injected with a similar volume of polyionic fluid . The TA treated group ( TA TX ) horses were treated with 12 mg of TA in the joint that contained the osteochondral fragment and the opposite intercarpal joint was injected with a similar volume of polyionic fluid . All horses were treated IA on days 13 and 27 after surgery and exercised on a high speed treadmill for 6 weeks starting on Day 14 . Horses in the TA TX group were significantly less lame than horses in the CNT and TA CNT groups . Horses in either TA CNT or TA TX groups had lower total protein , and higher hyaluronan , and glycosaminoglycan concentrations in synovial fluid than did those in the CNT group . Synovial membrane collected from subjects in TA CNT and TA TX groups had significantly less inflammatory cell infiltration , subintimal hyperplasia and subintimal fibrosis compared to the CNT group . Articular cartilage histomorphological parameters were significantly better from the TA CNT and TA TX groups compared to the CNT group . In conclusions , results from this study support favourable effects of TA on degree of clinical ly detectable lameness , and on synovial fluid , synovial membrane , and articular cartilage morphological parameters , both with direct intra-articular administration and remote site administration as compared to placebo treatment . The clinical use of IA administered TA in horses may be therapeutically beneficial in selected cases of osteochondral fragmentation and osteoarthritis
According to the World Health organization ( WHO ) , more than 10 % in people older than 60 years suffer from osteoarthritis ( OA ) .
Over the last years , there has been an increased interest around regenerative medicine , especially regarding stem cell treatments and related applications .
We hypothesize that stem cell therapies can represent a feasible option for idiopathic knee OA , delaying or even avoiding the joint replacement .