The role of arthroscopy in intra‐articular adipose tissue‐derived mesenchymal stem cells for the treatment of early‐stage knee osteoarthritis: A bicentric retrospective comparative study
Bibliographic record
Abstract
Abstract Purpose To determine the difference in clinical scores and re‐intervention rates in patients receiving intra‐articular adipose‐derived mesenchymal stromal cells (AD‐MSCs) as a stand‐alone treatment for knee osteoarthritis (OA) compared to patients receiving the same treatment following arthroscopic debridement and lavage. Methods Internal records at two orthopaedic centres were reviewed, and all consecutive patients with Kellgren–Lawrence II–III knee OA who had received intra‐articular AD‐MSC during 2017–2018 were included. The patients were stratified into two cohorts depending on whether they also received debridement arthroscopy. Patients were evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) scores as well as re‐intervention rates with a last available follow‐up of 5 years after the intra‐articular AD‐MSC injection. Results A total of 135 patients were enroled, 66 (49%) patients were male and 69 (51%) were female. The mean age at the time of intervention was 66 (range: 43–81) years. About half of the cohort ( n = 68) received a diagnostic and therapeutic arthroscopy (intervention) procedure in the same setting, whereas the other half ( n = 67) received intra‐articular AD‐MSCs without an arthroscopic procedure (control). Totally, 94% reported improved VAS scores post‐operatively. Seventy‐two patients (53%) had good symptomatic control at 5 years after the intra‐articular AD‐MSCs injection (VAS score range 0–3). Within this group, 57% of the patients had also received arthroscopy as part of their treatment, whereas the remaining patients had only received the intra‐articular injection of AD‐MSCs. Overall, WOMAC (46 arthroscopy + AD‐MSC, 58 AD‐MSC, p < 0.0001) and functionality (34 arthroscopy + AD‐MSC, 43 AD‐MSC, p < 0.0001) scores were superior in the cohort who also received debridement arthroscopy at the 5‐year follow‐up. Conservative re‐intervention rates, such as hyaluronic acid injections, were comparable amongst the cohorts. Conclusion Overall, debridement arthroscopy with AD‐MSC is favoured over stand‐alone MSC in Kellgren–Lawrence I–III knee OA. Level of Evidence Level III, retrospective comparative study.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".