Treatment of osteoarthritic knee with high tibial osteotomy and allogeneic human umbilical cord blood–derived mesenchymal stem cells combined with hyaluronate hydrogel composite
Bibliographic record
Abstract
BACKGROUND: Delaying total knee arthroplasty is crucial for middle-aged patients with severe osteoarthritis. The long-term outcomes of high tibial osteotomy (HTO) remain uncertain. Recently, mesenchymal stem cells (MSCs) have shown promising potential in enhancing cartilage regeneration. Therefore, this study aimed to assess cartilage regeneration following the implantation of allogeneic human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) with HTO. METHODS: . Clinical outcomes, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS), Physical Component Score (PCS) and Mental Component Score (MCS) from the 36-Item Short-Form Health Survey (SF-36), were evaluated 6 months, 1 year, and 2 years postoperatively. Cartilage status of the medial femoral condyle (MFC) was assessed during hardware removal surgery, at least 2 years after the initial procedure, and compared with preoperative MFC cartilage status regarding lesion size and International Cartilage Repair Society (ICRS) grade. Radiological assessments included the Kellgren-Lawrence (KL) grading system for medial compartment osteoarthritis and hip-knee-ankle (HKA) angle. RESULTS: Significant improvements were observed in WOMAC scores (preoperative: 57.00 (range: 44.75-63.00), postoperative: 27.50 (range: 22.25-28.75)), VAS scores (preoperative: 66.25 (range: 48.00-74.25), postoperative: 26.25 (range: 14.50-31.13)), SF-36 PCS (preoperative: 27.97 (range: 26.64-31.25), postoperative: 55.31 (range: 51.64-62.50)), and SF-36 MCS (preoperative: 41.04 (range: 29.95-50.96), postoperative: 63.18 (range: 53.83-65.16)) 2 years postoperatively (p = 0.002, 0.002, 0.002, and 0.020, respectively). The MFC chondral lesion demonstrated significant improvement in both lesion size (preoperative: 7.00 cm² (range: 4.38-10.50 cm²), postoperative: 0.16 cm² (range: 0.00-1.75 cm²), p = 0.002) and ICRS grade (preoperative: 4 (range: 4-4), postoperative: 1 (range: 1-2.25), p = 0.002). Additionally, the KL grade significantly decreased from 3 (range: 3-3) preoperatively to 2 (range: 2-2) postoperatively, while the HKA angle was corrected from 7.50° (range: 7.00-10.25°) preoperatively to -1.00° (range: -3.5-0.00°) postoperatively. CONCLUSIONS: hUCB-MSC implantation with HTO is an effective treatment for medial compartment osteoarthritis and varus deformities, resulting in significant improvements in cartilage regeneration and overall clinical outcomes. TRIAL REGISTRATION: NCT04234412.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".