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Osteoarthritis of the knee

Baseline magnetic resonance imaging findings associated with short-term clinical outcomes after intraarticular administration of autologous adipose-derived stem cells for knee osteoarthritis

Ryota Yamagami, Tomohiro Terao, Taro Kasai, Hisatoshi Ishikura, Masaki Hatano, Junya Higuchi, Shuichi Yoshida, Yusuke Arino, Ryo Murakami, Masashi Sato, Yuji Maenohara, Yuma Makii, Tokio Matsuzaki, Keita Inoue, Shinsaku Tsuji, Sakae Tanaka, Taku Saito
Regenerative Therapy 28（2025）：227-234.　DOI： 10.1016/j.reth.2024.12.012 

Research Summary

  • Subjects: A total of 149 patients with varus-type knee osteoarthritis showed no improvement after conservative treatment.
  • Treatment: A single intra-articular injection of autologous adipose-derived stem cells was administered to the affected knee joint.
  • Evaluation Methods:
    • The relationships between pretreatment MRI findings and patient 　background (age, sex, and body mass index), knee injury and Osteoarthritis Outcome Score (KOOS*), and treatment efficacy (OMERACT-OARSI responder rate) were evaluated.
    • Temporal changes in KOOS scores were assessed at baseline and 1, 3, 6, and 12 months after treatment.

Results

  • In the overall analysis of the patient cohort, all KOOS subscales (pain, symptoms, ADL, sports and recreation, and QOL) showed significant improvement at 6 months post-treatment compared to baseline, and these improvements were maintained up to 12 months after treatment.
  • According to the MRI-based classification of osteoarthritis severity, patients with mild-to-moderate OA had a significantly higher response rate than those with severe OA (response rate at 6 months: mild to moderate, 65.4%; severe, 35.2%).
  • Regarding patient background, younger patients showed significantly higher response rates (odds ratio, 1.04; P = 0.042).
  • Among other MRI findings, patients with smaller bone marrow lesions (BMLs) in the medial femoral condyle and fewer meniscal extrusions had significantly higher response rates.

Conclusion

Autologous adipose-derived stem cell therapy for knee osteoarthritis has been shown to have a treatment response that is associated with MRI findings such as disease severity, extent of BMLs in the medial femoral condyle, and medial meniscal extrusion in younger patients.
Moreover, this therapy significantly improved patient-reported outcomes in short-term clinical assessments.

Osteoarthritis of the hip

Intra-articular administration of autologous adipose-derived stem cells in hip osteoarthritis: Longitudinal treatment trajectories and prognostic factors.

Masaki Hatano, Hisatoshi Ishikura, Tomohiro Terao, Taro Kasai, Ryota Yamagami, Junya Higuchi, Shuichi Yoshida, Yusuke Arino, Ryo Murakami, Masashi Sato, Yuji Maenohara, Yuma Makii, Tokio Matsuzaki, Keita Inoue, Shinsaku Tsuji, Sakae Tanaka, Taku Saito
Regenerative Therapy 29 (2025) 217-226  　DOI: 10.1016/j.reth.2025.03.01

Research Summary

  • Subjects: A total of 129 patients (168 hips) with osteoarthritis (OA) of the hip.
  • Treatment: A single intra-articular injection of autologous adipose-derived stem cells (ASCs) was administered to the affected hip joint.
  • Evaluation Methods:
    • The Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) scores were assessed at baseline and at 1, 3, and 6 months after treatment.
    • Temporal changes in JHEQ scores were analyzed using a mixed-effects model, and comparisons were made across the entire cohort and between subgroups stratified by OA severity (Kellgren–Lawrence classification).
    • A mixed-effects model, including patient background, OA severity, and pretreatment MRI findings, was used to explore the predictive factors associated with treatment efficacy.

Results

  • In the overall analysis, the JHEQ scores significantly increased at 1, 3, and 6 months after treatment compared to baseline. The predicted change in JHEQ score at 6 months post-treatment, estimated using the mixed-effects model, was +10.6 points (95% CI: 8.3–12.8).
  • A significant effect of OA severity was observed on post-treatment JHEQ scores (P = 0.016).
  • Moderate OA (P = 0.028) and female sex (P = 0.025) were identified as favorable prognostic factors for treatment response, whereas damage to the femoral head ligament teres was found to be an unfavorable prognostic factor (P = 0.011).

Conclusion

ASC therapy for hip osteoarthritis improved short-term patient-reported outcomes, suggesting that the treatment efficacy may vary depending on the severity of OA. Female and moderate OA were identified as favorable prognostic factors. In contrast, damage to the ligamentum teres of the femoral head was suggested as an unfavorable prognostic factor for treatment response.