OUR EXPERIENCE IS THE USE OF STROMAL VASCULAR FRACTION IN OSTEOARTHRITIS OF THE KNEE JOINT
DİZ OYNAĞININ OSTEOARTRİTİNDƏ STROMAL DAMAR FRAKSİYASININ İSTİFADƏSİNDƏ TƏCRÜBƏMİZ
НАШ ОПЫТ ПРИМЕНЕНИЯ СТРОМАЛЬНО-СОСУДИСТОЙ ФРАКЦИИ ПРИ ОСТЕОАРТРИТЕ КОЛЕННОГО СУСТАВА
S.U.ASILOVA, M.M.ABDULLAEV, A.SH.BABAKULOV, A.B.MIRZAYEV, V.X.TURSUNOV, X.E.ALIYEV
Tashkent Medical Academy, Akfa Medline Clinic.
Introduction
Currently, studies of adipose tissue stromal fraction (SVF) cells are attracting increasing attention because they have the potential to differentiate into many cell types, such as mesenchymal stromal cells (MSCs) derived from bone marrow, and they are easier to assemble than MSCs, which facilitates their clinical application. This study evaluated the short-term clinical results of SVF cell therapy for osteoarthritis of the knee joint.
The relevance of the problem: osteoarthritis of large joints in patients older than 60 years occurs from 8% to 40%, these indicators average 33.6%. According to WHO, osteoarthritis occurs in men on average in 9.6%, in women in 18%. In Europe, osteoarthritis occurs in 22% to 55% of people aged 40 to 80 with pathology of large joints and is considered the main cause of disability. Pain is the primary clinical symptom of osteoarthritis of the knee joint, which does not allow patients to lead an active lifestyle. In patients, the pain increases during walking, especially when descending the stairs. With palpation in the knee joint area along the course of the articular gap, starting from the medial to the lateral sections, patients note soreness, from minor 1-2 stages of arthrosis, to unbearable, pronounced at the third stage.
One of the modern methods of treatment, currently, the use of stromal vascular fraction (SVF) is very promising. SVF is obtained from adipose tissue and can be easily obtained during a standard liposuction procedure under local anesthesia. Lipoaspirate is a rich source of various types of cells involved in tissue regeneration, for example, precursors of endothelial cells, preadipocytes, fibroblasts, mast cells, macrophages, T- and B-lymphocytes. Thanks to this powerful auto-cocktail, the maximum effect is achieved to relieve inflammation, improve regeneration, stimulate local immunity and increase local blood supply.
The purpose of the study: the aim of the study was to study the results of treatment in patients with osteoarthritis of the knee joint of all stages by intra-articular injection of the stromal-vascular fraction.
Materials and methods: we operated on 31 (48 cases) patients diagnosed with osteoarthritis of the knee joint at various stages in the “Republican Clinical Hospital No. 1” and outpatient in the polyclinic “Family doctor’s” for 2022. The patients ranged in age from 34 to 65 years. Category of patients with knee joint DOA (gonarthrosis), I-IV art. according to Kellgren-Lawrence. Diagnostic methods such as: radiography, magnetic resonance imaging, densitometry were used.
Results: the assessment was carried out according to the average value of points on 3 indicators, to determine the improvement of clinical manifestations where: excellent result 0-1,3 points, there is no pain, complete restoration of mobility and walking. A good result is 1.4-2.9 points, while there is slight pain, with a slight restriction of mobility and walking. Satisfactory result 3.0-4.2 points disturbing pain with visible limitation of mobility and walking. Unsatisfactory result 4.3-5 points severe pain, with visible mobility restriction and not walking. The results were evaluated for 9 months. A good result in (1.4- 2.9b) 26 (73.3%) patients, a satisfactory result (3-4.2b) in 4 (26.7%) patients. Unsatisfactory result (4.3-5b) in 1 patient.
Discussion: the most important finding of this study was that several clinical parameters such as pain, joint mobility and walking significantly improved after intra-articular injection of SVF cells into the knee joints of patients with knee osteoarthritis. These results indicate that intra-articular injection of SVF cells into the knee joints is a safe and beneficial treatment that reduces the symptoms of osteoarthritis of the knee joint. One study reported that intra-articular injections of SVF cells in osteoarthritis of the knee joint provide better pain relief and clinical results than the administration of hyaluronic acid. Another study showed that SVF is superior to platelet-rich plasma in reducing pain associated with knee osteoarthritis from 1 month to 1 year after surgery. This may be due to the fact that SVF cells stimulate inhibitory macrophages and T-regulatory cells, which have a stronger analgesic effect due to a decrease in inflammatory markers. The use of SVF in osteoarthritis of the knee joint has proven to be a safe and effective method.
Conclusions:
- Stromal vascular fraction can be used in osteoarthritis in all stages.
- The effect of the stromal-vascular fraction depends on the stage of osteoarthritis, in the initial stages a high efficiency of the technique was obtained.
- How long will the effect of the stromal-vacular fraction last in osteoarthritis of stage 3-4.