In recent years there has been some debate about how far injection of stem cells (mesenchymal stem cells) from the bone marrow helps, particularly in patients undergoing hip arthroscopy who have chondropathy of the acetabulum or of the femoral head. A new study set out to determine the clinical outcome of intra-articular injection of stem cells (mesenchymal stem cells) taken from the iliac crest during hip arthroscopy, in patients with a symptomatic tear of the labrum of the acetabulum and early radiographic osteoarthritic changes.
This was a retrospective study in which data were collected from a database. Patients with Tönnis grade I and II osteoarthritic changes and a symptomatic tear of the labrum of the acetabulum who underwent hip arthroscopy with simultaneous stem cell injection were compared with those who underwent hip arthroscopy but without injection of these cells. Patient-reported outcomes were assessed up to two years postoperatively, including the modified Harris Hip Score, the Hip Outcome Score-Activities of Daily Living, the Hip Outcome Score-Sport and the International Hip Outcome Tool 33 score.
In all, 35 patients underwent hip arthroscopy in order to repair the labrum with simultaneous stem cell injection, and were compared with a further 35 patients. There were no differences in the demographic details of the patients. The first group consisted of 22 patients with Tönnis grade I osteoarthritic changes and 13 patients with Tönnis grade II, while the comparison group of 35 patients had Tönnis grade 0 osteoarthritic changes. All the assessment scales were compared at two years and there was no difference in improvement. The rate of conversion to total hip arthroplasty was 14.3% in the first group and 5.7% in the second.
The authors concluded that, in a group of patients who present a considerable challenge to the orthopaedic surgeon, and who have a tear of the labrum together with early osteoarthritic changes, hip arthroscopy with simultaneous injection of stem cells (mesenchymal stem cells) results in statistically significant improvement on the hip assessment scales, with results comparable to those of the group of patients with non-arthritic hips who undergo hip arthroscopy.
Source: “Arthroscopy”, June 2023