3D Expanded Stem Cell Culture for Hip Labral Tear Repair: Clinical Approach

This study examines the efficacy of using the intra-articular 3-Dimensional (D) mesenchymal stem cell (MSC) technique to repair hip labral tear as an alternative to orthopaedic surgery.

Chronic labral tear commonly occurs with repetitive trauma, particularly in athletes. Other causes include capsular hip hypermobility, femoroacetabular impingement, acetabular dysplasia, and hip osteoarthritis.

Given the trivial penetration of vessels into the labrum with poor blood supply, experts have concluded that no labrum area has the ability for repair, and no clinical studies to date show that labral tears do heal. A labral tear can be associated with chondral injury and the risk of developing premature osteoarthritis. Surgery is the only available choice in symptomatic cases by debriding and repairing labral tears and associated structural defects. The above logic is that MSCs express a chondrocyte differential perspective and produce extracellular matrix (ECM) molecules and regulatory signals, which may repair the damaged hip joint.

We report a thirty-Two-year male lawyer with an athletic background who suffered from right acetabular dysplasia that led to extensive labral tears and para-labral cysts. We treated him with experimental 3D expanded stem cell culture using FDA-approved bovine collagen type1 crossed-linked with hyaluronic acid to form a stable hydrogel. The surgeon did a corrective extra-articular osteotomy to his right hip one month after the stem cell therapy as a hip preserving approach. He had post-treatment physical rehabilitation. He reported a tremendous clinical and radiological response. Five and a half months post-treatment MRI revealed complete repair of extensive labral tears and total resolution of para-labral cysts. He returned to exercise comfortably with regular exercycle training and walking. This case stands for world exceptional results with successful clinical and radiological outcomes following experimental 3D stem cell culture with the benefit of adding an extracellular matrix to the treatment with an enormous potential for non-surgical tissue repair and regeneration of the joint structures. We highly recommend randomized controlled trials to show if those results are consistent.