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Objective: To analyze the potential modulatory effect of Cellular Matrix, a new medical device designed for the one-step preparation of platelet-rich plasma in presence of hyaluronic acid, on the structure of articular cartilage in patients suffering from knee osteoarthritis using high-field Magnetic Resonance Imaging measurements of longitudinal relaxation time after gadolinium injection. Methods: The treatment consisted of a series of 3 intra-articular injections scheduled at D0, D60 and D180 into the affected knee of six patients with Kellgren-Lawrence grades of 1.5 to 3. Magnetic Resonance Imaging acquisitions were performed before the first injection at D0 (baseline), at D180 (just after the third injection) and at D270 (3 months after the third injection). The efficacy criterion was the variation of T1 relaxation time in different selected cartilage regions. Results: Our study reveals a positive" time-dependent" structural effect of the combination of PRP and HA obtained with Cellular Matrix on the proteoglycan content of the knee joint cartilage. At D180, the weight-bearing areas were involved in two patients with Kellgren-Lawrence grades equal to or greater than 2. At D270, 5 patients showed an initial improvement in the weight-bearing area; only one patient with early external femoropatellar osteoarthritis (with a Kellgren-Lawrence grade of 1.5) had no improvement. Conclusion: This pilot study demonstrates for the first time the modulatory effect on the structure of the knee joint cartilage of a combination of platelet-rich plasma and hyaluronic acid prepared with a specially dedicated medical device (Cellular Matrix) during the course treatment. Cellular Matrix could therefore be considered a Disease Modifying Osteoarthritis Device.

High-field MRI exploration of the structural effects of cellular matrix™ on articular cartilage in knee osteoarthritis: A pilot study in 6 patients