Corrective osteotomy associated with PRP and SVF post-treatments and synovial cytokine assessment

10^th International Conference on Surgery and Anaesthesia

May 19-20, 2025 Zurich, Switzerland

Elena V Tchetina

Nasonova Research Institute of Rheumatology, Russian Federation

Scientific Tracks Abstracts: Surgery

Abstract :

Statement of the Problem: Knee osteoarthritis (KOA) is the most common musculoskeletal disease that results in articular cartilage damage and is accompanied by low-grade synovial inflammation and pain [1]. KOA treatment aims the relief of clinical symptoms, while it often ends up in advanced knee OA and requires total joint replacement [2]. To delay the total knee arthroplasty, corrective medial opening wedge high tibial osteotomy (HTO) is implicated [3,4]. However, the results of HTO might be associated with patient’s capacity for tissue regeneration [5]. Presently, it is well documented that human stem cells, such as adipose mesenchymal stem cells as a part of stromal vascular fraction (SVF) and platelet-rich-plasma (PRP) preparations were capable of repairing and regenerating injured tissues primarily in diseases associated with tissue loss or damage [6,7]. Objective: To examine functional outcomes and synovial fluid (SF) cytokine concentrations in response to PRP or SVF post-treatments following open wedge high tibial osteotomy. Methodology and Theoretical Orientation: Six weeks after surgery, the knees of 10 patients with knee osteoarthritis were injected with autologous PRP (PRP subgroup), while another 10 patients were injected with autologous SVF (SVF subgroup) and monitored for 1.5 years. Pain assessment (VAS score) and functional activity (KOOS, KSS, Outerbridge, Koshino scores) were applied. SF was collected before and one week after PRP or SVF injections and tested for concentrations of 41 cytokines (Multiplex Assay). Findings: PRP subgroup performed better compared with the SVF subgroup according to KOOS, KSS, and VAS scores, while the SVF subgroup demonstrated superior results in Outerbridge and Koshino testing. In the PRP subgroup, a significant decrease in IL-6 and CXCL10 synovial concentrations was observed. The SVF subgroup demonstrated a significant decrease in synovial TNFα, FLT-3L, MIP-1β, RANTES, and VEGF concentrations. Conclusion & Significance: Intra-articular administration of SVF produced more pronounced improvements related to cartilage regeneration while PRP post-injection resulted in a better functional outcome and pain control.Recent Publications 1. Stoddart, J.C. et al. Osteoarthr. Cartil. 2021, 29, 445–455. 2. Khan, M.et al. Pol. Arch. Intern. Med. 2018, 128, 121–125. 3. Saito, T. et al. Bone Jt. J. 2014, 96, B339–B344. 4. Sundararajan, S.R. et al. Arthroscopy 2017, 33, 586–594. 5. Bhan, S. et al. Int. Orthop. (SICOT) 1992, 16, 13–17. 6. Shen, L. et al. J. Orthop. Surg. Res. 2017, 12, 16. 7. Shanmugasundaram, S. e al. Int. Orthop. 2021, 45, 615–625.

Biography :

Elena Tchetina is a Leading Scientist, Principle Investigator, Immunology & Molecular Biology Department, of NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY, at Moscow, Russia since Oct.2006- until present. She studies genetics, cellular, and molecular physiology of osteoarthritis, rheumatoid arthritis, and osteoporosis. The importance of metabolic signalling pathways for the disease progression, inflammation, pain perception, joint destruction, and the response to therapy has been investigated in osteoarthritic, rheumatoid arthritis, and osteoporotic patients. Previously, from Nov.1996 until Sept.2006, she worked at McGILL UNIVERSITY, at Montreal, Canada at Shriners Hospitals for Children, at the Joint Diseases Laboratory, as Research Associate and conducted research in molecular cell biology, connective tissue physiology and bone development: She studied the mechanisms of the onset of cartilage degradation in osteoarthritis (OA) at gene expression and protein level.