Does intra-articular injection of adipose-derived stem cells improve cartilage mass? A case report using three-dimensional image analysis software in knee osteoarthritis

Abstract

Background: Mesenchymal stem cells are currently a research focus because of the possibility of cartilage regeneration through several mechanisms, including mesenchymal stem cell sheets. However, there are no published reports visualizing cartilage in three dimensions. Here, we report a case of improved cartilage volume. We purified and cultured adipose-derived mesenchymal stem cells and then performed adipose-derived mesenchymal stem cell therapy by directly injecting these cells into the articular cartilage. Cartilage was quantitatively evaluated before and after injection using three-dimensional image analysis software based on the magnetic resonance imaging. Case presentation: The patient, a 55-year-old Japanese woman, experienced pain in both knees and was diagnosed with osteoarthritis of the knee. We performed adipose-derived mesenchymal stem cell therapy in both knees at our hospital and quantitatively evaluated cartilage before and after the treatment using the three-dimensional image analysis software “SYNAPSE VINCENT”. Conclusions: Preoperatively, the cartilage defect area was 33.59 mm2 in the femur and 122.31 mm2 in the tibia; however, 12 months postoperatively, it improved to 13.59 mm2 and 51.43 mm2, respectively. Furthermore, the preoperative femur and tibia volumes were 9.58 mL and 3.82 mL, respectively; however, 12 months postoperatively, these values improved to 10.00 mL and 4.17 mL, respectively. For the quantitative analysis of cartilage, SYNAPSE VINCENT visualizes the state of cartilage in a high-definition three-dimensional image, which is excellent for understanding the state of the disease and explaining it to the patient. Although SYNAPSE VINCENT can only analyze the thickness of cartilage, and the reproducibility of the error is debatable, SYNAPSE VINCENT would be useful as a clinical tool for regenerative medicine. We have shown in this case report the promising effects of adipose-derived stem cell intraarticular injections in treating osteoarthritis and the use of new diagnostic instruments.