Hassan MubarkAuckland Regnerative Clinic, New Zealand
Title: Resolution of patellofemoral bone marrow edema and subchondral cysts on mri post a single autologous fat-derived expanded mesenchymal stem cell therapy
Bone marrow edema and subchondral bone cysts are common findings in the different stages of knee osteoarthritis, those pathologies are usually seen on MRI imaging. Once the degenerative process starts, it evolves into severe osteoarthritis and ultimately requires knee replacement over time. Herein we report a case of a fifty-four-year-old male who adores active sports. He presented with symptomatic right knee osteoarthritis; an MRI scan uncovered compound patellofemoral subchondral bone marrow edema and subchondral cysts with a medial meniscus tear, in addition to medial and patellofemoral cartilage loss altogether with large baker cyst and synovitis. He failed ultrasound-guided steroid injection but responded significantly to a single dose of autologous fat-derived expanded mesenchymal stem cells (MSCs) combined with platelet-rich plasma (PRP). He became symptoms-free three months post-therapy. Nine months following the treatment, he remains asymptomatic, and a repeat MRI showed a tiny baker cyst and a considerable reduction of synovitis as a result of an anti-inflammatory effect of MSCs. A follow-up MRI thirty-three months post-therapy uncovered full resolution of both bone marrow edema and multiple subchondral patellofemoral bone cysts. This case represents a positive clinical and radiological outcome subsequent to single expanded mesenchymal stem cell therapy for knee osteoarthritis.
Dr Mubark is an experienced joint disease specialist with more than 30 years in medical practice. Specializing in Rheumatology from 2007, he became particularly interested in musculoskeletal and sports medicine as well as regenerative medicine. For many years he has worked in this field, starting with plasma (PRP) then moving to autologous fat-derived expanded mesenchymal stem cells therapy with growing interest over the past few years. Dr Mubark is an experienced joint disease specialist with more than 30 years in medical practice. Specializing in Rheumatology from 2007, he became particularly interested in musculoskeletal and sports medicine as well as regenerative medicine. For many years he has worked in this field, starting with plasma (PRP) then moving to autologous fat-derived expanded mesenchymal stem cells therapy with growing interest over the past few years. His main interest is interventional procedures that could lead to permanent life changes for patients. Dr Mubark’s treatment has seen several significant published successes in Orthopaedic journals, including treating the most challenging cases involving world champions to a number of published medical cases with success stories from knee, hip, shoulder, Achilles tendon and hands osteoarthritis and tendon tears. Despite being used overseas, stem cell therapy is classed as an ‘experimental or alternative’ procedure for musculoskeletal conditions in New Zealand and we follow and respect medico-ethical rules of the medical council and MedSafe, we perform our procedure using freedom of choice approach and informed consent. In New Zealand stem cell therapy is not funded by ACC and not offered within the public health system, but occasionally may be covered by private health insurance. Dr Mubark believes this procedure will eventually be available to all Kiwis, once sufficient research is published, and our medical fraternity have time to understand this complex new area of medicine. Stem cell therapy, when offered early to patients, has 70-80% success rate of controlling symptoms and improving quality of life. The idea is to slow or stop the progression of the degenerative joint disease and help tendon tear. Born in Iraq and trained at Baghdad University, Dr Mubark has had extensive hospital training in various specialties of general medicine, surgery, orthopaedics, and various other branches of medicine. Dr Mubark settled in New Zealand in 1995 and has worked ever since to bring the latest advances in medical science to his Kiwi patients with two main aims, to help those suffering from arthritis and injury, and to keep New Zealand at the forefront of world-leading medical science. Dr Mubark is working hard to bring the latest advances with two main aims - to help arthritis and injuries sufferers and to let New Zealand lead the world with good science. This determination has resulted in him receiving an award in 2023 for “Global Recognition for Innovative Stem Cell Therapy”.