Ankle synovium-derived mesenchymal stem cells for the treatment of osteochondral lesion of the talus: a novel cell harvesting technique and clinical applications

C. Angthong, H. Kunkanjanawan

Department of Orthopaedics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand Medeze Research and Development, Nakhon Pathom, Thailand. chatthara@yahoo.com

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• Orthopedics

OBJECTIVE: To describe a novel technique for harvesting mesenchymal stem cells (MSCs) from ankle synovium and demonstrate their multipotency for chondrogenesis and osteogenesis in the treatment of a large osteochondral lesion of the talus (OLT).
PATIENTS AND METHODS: MSCs were harvested under local anesthesia from a biopsy of the ankle synovium of a patient with OLT and cultured for 4 weeks. In accordance with the International Society for Cellular Therapy (ISCT) criteria, synovial-derived MSCs were analyzed for cell surface markers using flow cytometry and grown in differentiation induction medium to demonstrate multilineage differentiation potentials in vitro. The patient received an injection of synovial-derived MSCs in a collagen matrix with a fibrin sealant to augment surgery for the lesion.
RESULTS: Harvesting of ankle synovium yielded a culture of 30 million spindle-shaped stem cells in 4 weeks. Cell surface marker expression of the MSCs met the ISCT standards. After 21 days, cultured cells could be differentiated into adipocytes, osteocytes and chondrocytes. The patient recovered uneventfully from surgery and showed satisfactory improvements in pain and ankle motion.
CONCLUSIONS: Ankle synovium is a potential source of MSCs for the treatment of OLT. We developed a novel harvesting technique that was simple, convenient and had no complications.

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