Zhang SY, Xu HH, Xiao MM, Zhang JJ, Mao Q, He BJ, Tong PJ. Subchondral bone as a novel target for regenerative therapy of osteochondritis dissecans: A case report. World J Clin Cases 2021; 9(15): 3623-3630 [PMID: 34046461 DOI: 10.12998/wjcc.v9.i15.3623]
Corresponding Author of This Article
Pei-Jian Tong, MD, Chief Doctor, Professor, Department of Orthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. tongpeijian@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sheng-Yang Zhang, Hui-Hui Xu, Jing-Jing Zhang, Institute of Orthopedics and Traumatology, The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Miao-Miao Xiao, The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Qiang Mao, Bang-Jian He, Pei-Jian Tong, Department of Orthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Author contributions: Zhang SY, Xu HH, Xiao MM, and Zhang JJ collected the information, followed the patient, and wrote the paper; Mao Q and He BJ revised the paper; Tong PJ was the patient’s orthopedic surgeon and performed the surgery; all authors read and approved the final manuscript.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Pei-Jian Tong, MD, Chief Doctor, Professor, Department of Orthopedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, No. 54 Youdian Road, Hangzhou 310006, Zhejiang Province, China. tongpeijian@163.com
Received: January 5, 2021 Peer-review started: January 5, 2021 First decision: January 17, 2021 Revised: January 28, 2021 Accepted: March 3, 2021 Article in press: March 3, 2021 Published online: May 26, 2021 Processing time: 126 Days and 7.5 Hours
Abstract
BACKGROUND
Osteochondritis dissecans (OCD) is a rare disease of unclear cause characterized by subchondral bone damage and overlying cartilage defects. The current report presents the results of subchondral bone as a novel target for implantation of peripheral blood stem cells (PBSCs) in the treatment of OCD.
CASE SUMMARY
A 16-year-old patient diagnosed with OCD underwent subchondral bone implantation of PBSCs. Four months later, the patient's visual analog scale scores, Western Ontario and McMaster University osteoarthritis index, and whole-organ magnetic resonance imaging score improved significantly, and regeneration of cartilage and subchondral bone was observed on magnetic resonance imaging.
CONCLUSION
This is the first case of OCD treated with subchondral bone as an implantation target of PBSCs, which highlights the importance of subchondral bone for cartilage repair. This treatment could be a potential option for articular cartilage and subchondral bone recovery in OCD.
Core Tip: Osteochondritis dissecans is a relatively rare disease, and we used an unreported treatment that focused on subchondral bone as a novel target for implantation using peripheral blood stem cells. Magnetic resonance imaging at 4 mo postoperatively showed repair of both cartilage and subchondral bone, and the patient's knee function and pain improved.
