自体滑膜间充质干细胞移植增强半月板修复术后8年临床与影像学结果：一项长期随访病例系列
简介
该研究纳入6例接受自体滑膜间充质干细胞（MSC）移植辅助内侧半月板修复的患者，进行8年随访。结果显示所有患者Lysholm评分在1年时显著改善并维持至8年，5例达到满分100分；影像学上无内侧关节间隙明显狭窄进展，无严重不良事件或再手术。提示滑膜MSC移植作为半月板修复的生物增强手段，在长期安全性和临床改善方面具有可行性，但样本量小且无对照组。
英文摘要
BACKGROUND: Biological augmentation using synovial mesenchymal stem cells (MSCs) has been proposed to enhance healing after meniscal repair, particularly the repair of degenerative flap and radial tears with poor intrinsic healing potential. This study evaluated the 8-year outcomes after meniscal repair augmented with autologous synovial MSC transplantation, focusing on clinical results, radiographic changes, and adverse events. METHODS: Nine patients had previously been enrolled in an investigator-initiated clinical trial of autologous synovial MSC transplantation for medial meniscal tears. Of these, six completed the 8-year follow-up and were included. Clinical outcomes were assessed using the Lysholm knee score at screening, 1 year, and 8 years. Radiographic evaluation used standing anteroposterior knee radiographs and a modified Kellgren-Lawrence (KL) grading system. Adverse events and reoperations were assessed through annual follow-ups. RESULTS: All six patients maintained the Lysholm score improvement observed at 1 year throughout the 8-year follow-up. Five of the six patients achieved the maximum Lysholm score of 100, and the remaining patient scored 99. The Lysholm score was significantly higher at 1 and 8 years than at screening (both P=0.031, Wilcoxon signed-rank test). Radiographically, four patients showed no KL grade change, while two demonstrated progression characterized by osteophyte enlargement or onset. No apparent progression of medial joint space narrowing was observed in this cohort. No patient experienced a serious adverse event, reoperation, infection, thromboembolic event, hospitalization, or abnormal radiographic finding, such as ectopic ossification or tumor formation. CONCLUSIONS: Meniscal repair augmented with autologous synovial MSC transplantation was associated with sustained clinical improvement over 8 years in this small cohort, with no apparent progression of medial joint space narrowing on plain radiographs or treatment-related serious adverse events. These findings suggest that synovial MSC transplantation is a feasible, safe, and potentially durable biological adjunct to meniscal repair.