Purpose: To determine the safety, feasibility and effectiveness (clinical and radiological) of intra-articular administration of autologous mesenchymal stem cells (MSCs) with platelet richa plasma (PRGF) in patients with knee osteoarthritis. Patients and methods Clinical trial phase I- II, randomized , multicenter , with two treatment arms and 19 patients for each group. The investigators compare the intraarticular injection of against the administration of two different doses of mesenchymal stem cells with hialuronic acid according to the following scheme: 1. Group A: 3 intra-articular injections of platelet rich plasma (PRGF®) separated by 7 days. 2. Group B: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days and one with Mesenchimal stems cells. Intra-articular injection of 100 million autologous mesenchymal progenitor stem cells cultured ex - vivo (cell suspension sterile small volume (5-10 ml ) in a vehicle suitable for intraarticular injection ) followed by an intraarticular injection of platelet richa plasma (PRGF®). The treatment is completed with 2 more injection of platelet richa plasma (PRGF®) separeted by one week. In addition the investigators assess the response to intra-articular infusion of CMM analyzing the following parameters: * Clinical assessment of pain and function (Baseline, 1, 3, 6 and 12 months since treatment): VAS , WOMAC , KOOS , EuroQol, SF-16, Lequesne , WOMAC , KOOS. * Radiographic (baseline and 12 months from treatment): Femorotibial space. * Radiographic using MRI (baseline and 12 months from treatment): by assessing the number location of the lesions , cartilage thickness , signal intensity , subchondral bone alteration , volume and WORMS and dGEMRIC protocols.
Purpose: To determine the safety, feasibility and effectiveness (clinical and radiological) of intra-articular administration of autologous mesenchymal stem cells (MSCs) with platelet richa plasma (PRGF®) in patients with knee osteoarthritis. Patients and methods Clinical trial phase I- II, randomized , multicenter , with two treatment arms and 19 patients for each group. The investigators compare the intraarticular injection of against the administration of two different doses of mesenchymal stem cells with hialuronic acid according to the following scheme: 1. Group A: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days. 2. Group B: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days and one with Mesenchimal stem cell. Intra-articular injection of 100 million autologous mesenchymal progenitor stem cells cultured ex - vivo (cell suspension sterile small volume (5-10 ml ) in a vehicle suitable for intraarticular injection ) followed by an intraarticular injection of platelet richa plasma (PRGF®). The treatment is completed with 2 more injection of platelet richa plasma (PRGF®) separeted by one week. The autologous mesenchymal stem cells are obtained from the iliac crest under local anesthesia and sedation. They are cultured ex vivo The primary endpoint is safety and feasibility. The investigators registered the occurrence of complications and / or adverse effects during the study. In addition the investigators assess the response to intra-articular infusion of CMM analyzing the following parameters: * Clinical assessment of pain and function (Baseline, 1, 3, 6 and 12 months since treatment): VAS , WOMAC , KOOS , EuroQol, SF-16, Lequesne , WOMAC , KOOS. * Radiographic (baseline, 6 and 12 months since treatment): Femorotibial space. * Radiographic using MRI (baseline, 6 and 12 months since treatment): by assessing the number location of the lesions , cartilage thickness , signal intensity , subchondral bone alteration , volume and WORMS and dGEMRIC protocols. All patients met the following inclusion and exclusion criteria:
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
38
100 million Bone marrow mesenchimal stem cells with PRGF
3 injections of PRGF
Hospital Universitario de Salamanca
Salamanca, Castille and León, Spain
Departamento Cirugía Ortopédica y Traumatología. Clinica Universidad de Navarra
Pamplona, Navarre, Spain
Baseline Visual analogue scale (VAS) Baseline Visual analogue scale (VAS)
Baseline Visual analogue scale (VAS) prior to the initial dose on day 1
Time frame: Day 1
Baseline value of knee injury and osteoarthritis outcome score (Koos).
Prior to the intervention on day 1 value of knee injury and osteoarthritis outcome score (Koos).
Time frame: Day 1
Baseline Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC).
Universities Osteoarthritis Index score (WOMAC).
Time frame: Day 1
Baseline SF-36 value
Baseline SF-36 value
Time frame: Day 1
Baseline euroquol 5D value
Pretreatment euroquol 5D value
Time frame: Day 1
Baseline Lequesne index
Prior to the intervention on day 1 Lequesne index
Time frame: Day 1
Baseline femorotibial distance
Prior to the intervention femoritibial distance on rosenberg x-ray view
Time frame: Day 1
Number of Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events
Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events During the follow up
Time frame: Follow up (up to 12 months)
Visual analogue scale (VAS) at 1 month
Visual analogue scale (VAS) at on month
Time frame: 1 month
Visual analogue scale (VAS) at 3 months
Visual analogue scale (VAS) at 3 months
Time frame: 3 months
Visual analogue scale (VAS) at 6 months
Visual analogue scale (VAS) at 6 months
Time frame: 6 months
Visual analogue scale (VAS) at 12 months
Visual analogue scale (VAS) at 12 months
Time frame: 12 months
Value of knee injury and osteoarthritis outcome score (Koos) at 1 month
Value of knee injury and osteoarthritis outcome score (Koos) at 1 month
Time frame: 1 month
Value of knee injury and osteoarthritis outcome score (Koos) at 3 month
Value of knee injury and osteoarthritis outcome score (Koos) at 3 month
Time frame: 3 Months
Value of knee injury and osteoarthritis outcome score (Koos) at 6 month
Value of knee injury and osteoarthritis outcome score (Koos) at 6 month
Time frame: 6 months
Value of knee injury and osteoarthritis outcome score (Koos) at 12 months
Value of knee injury and osteoarthritis outcome score (Koos) at 12 months
Time frame: 12 months
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