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Percutaneous injection of autologous, culture-expanded mesenchymal stem cells into carpometacarpal hand joints: a case series with an untreated comparison group

Perkutane Injektion von autologen, kulturexpandierten mesenchymalen Stammzellen in das Karpometakarpalgelenk des Daumens: eine Fallstudie mit einer unbehandelten Kontrollgruppe

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Summary

In the present study, we describe six patients who received autologous mesenchymal stem cell (MSC) therapy for symptomatic carpometacarpal (CMC) joint and hand osteoarthritis (OA). Six patients who received injections of adult autologous culture expanded MSCs in their thumb CMC joints were followed for 1 year posttreatment, and matched with four procedure candidates who remained untreated. We observed positive outcomes in the treatment group for both symptoms and function related to the OA, compared with a reported worsening among the untreated controls. While these results should be interpreted with caution because of the small number of treated subjects and lack of placebo control and randomization, we find sufficient evidence for further investigation of MSC therapy as an alternative to more invasive surgery in patients with OA of the hand.

Zusammenfassung

In der vorliegenden Studie beschreiben wir sechs Patienten, welche eine autologe mesenchymale Stammzelltherapie aufgrund einer symptomatischen Karpometakarpalgelenks- oder Handosteoarthrose erhielten. Sechs Patienten, die Injektionen von adulten autologen kulturexpandierten mesenchymalen Stammzellen in das Karpometakarpalgelenk des Daumens erhalten hatten, wurden über ein Jahr nachverfolgt und mit vier Patienten, welche unbehandelt geblieben sind, verglichen. In der Behandlungsgruppe wurden sowohl im Hinblick auf die Symptome als auch auf die gelenksbezogene Funktion positive Auswirkungen beobachtet, während es bei den unbehandelten Kontrollen zu einer Verschlechterung kam. Aufgrund der geringen Zahl der behandelten Patienten und dem Fehlen eines Randomisierungsverfahrens sowie einer Plazebo- Kontrollgruppe müssen diese Ergebnisse mit Vorsicht interpretiert werden. Nichtsdestotrotz stellen unsere Ergebnisse eine Evidenz dar, um weitere Forschungen über die mesenchymale Stammzelltherapie als eine Alternative zu invasiveren chirurgischen Maßnahmen bei Patienten mit Handosteoarthrose durchzuführen.

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Conflict of interest

Dr. Centeno is a shareholder and director of Regenerative Sciences, LLC. Dr. Freeman has no conflicts of interest.

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Authors and Affiliations

  1. Department of Public Health & Preventive Medicine, Oregon Health & Science University School of Medicine, Portland, Oregon, USA

    Michael D. Freeman PhDMPH

  2. Section of Forensic Medicine, Umeå University, Umeå, Sweden

    Michael D. Freeman PhDMPH

  3. Department of Forensic Medicine, Aarhus University, Aarhus, Denmark

    Michael D. Freeman PhDMPH

  4. Centeno Schultz Clinic, Broomfield, CO, USA

    Christopher J. Centeno MD

Authors
  1. Christopher J. Centeno MD
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  2. Michael D. Freeman PhDMPH
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Correspondence to Michael D. Freeman PhDMPH.

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J. Centeno, C., D. Freeman, M. Percutaneous injection of autologous, culture-expanded mesenchymal stem cells into carpometacarpal hand joints: a case series with an untreated comparison group. Wien Med Wochenschr 164, 83–87 (2014). https://doi.org/10.1007/s10354-013-0222-4

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