scholarly journals Functional Outcomes Following Microfragmented Adipose Tissue Versus Bone Marrow Aspirate Concentrate Injections for Symptomatic Knee Osteoarthritis

2019 ◽  
Vol 8 (11) ◽  
pp. 1149-1156 ◽  
Author(s):  
Kenneth Mautner ◽  
Robert Bowers ◽  
Kirk Easley ◽  
Zachary Fausel ◽  
Ryan Robinson
Keyword(s):  
Bone Marrow ◽  
Adipose Tissue ◽  
Knee Osteoarthritis ◽  
Functional Outcomes ◽  
Bone Marrow Aspirate ◽  
Bone Marrow Aspirate Concentrate ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

scholarly journals Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial

2020 ◽  
Vol 8 (2) ◽  
pp. 232596711990095 ◽  
Author(s):  
Adam W. Anz ◽  
Ryan Hubbard ◽  
Nicole K. Rendos ◽  
Peter A. Everts ◽  
James R. Andrews ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Clinical Evidence ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
The United States ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Symptomatic Knee

Background: Approximately 47 million people in the United States have been diagnosed with arthritis. Autologous platelet-rich plasma (PRP) injections have been documented to alleviate symptoms related to knee osteoarthritis (OA) in randomized controlled trials, systematic reviews, and meta-analyses. Autologous bone marrow aspirate concentrate (BMC) injections have also emerged as a treatment option for knee OA, with a limited clinical evidence base. Purpose: To compare the efficacy of BMC to PRP for the treatment of knee OA regarding pain and function at multiple time points up to 12 months after an injection. We hypothesized that BMC will be more effective in improving outcomes in patients with knee OA. Study Design: Randomized controlled trial; Level of evidence, 2 Methods: A total of 90 participants aged between 18 and 80 years with symptomatic knee OA (Kellgren-Lawrence grades 1-3) were randomized into 2 study groups: PRP and BMC. Both groups completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subjective International Knee Documentation Committee (IKDC) questionnaires before and 1, 3, 6, 9, and 12 months after a single intra-articular injection of leukocyte-rich PRP or BMC. Results: There were no statistically significant differences in baseline IKDC or WOMAC scores between the 2 groups. All IKDC and WOMAC scores for both the PRP and BMC groups significantly improved from baseline to 1 month after the injection ( P < .001). These improvements were sustained for 12 months after the injection, with no difference between PRP and BMC at any time point. Conclusion: Both PRP and BMC were effective in improving patient-reported outcomes in patients with mild to moderate knee OA for at least 12 months; neither treatment provided a superior clinical benefit. Autologous PRP and BMC showed promising clinical potential as therapeutic agents for the treatment of OA, and while PRP has strong clinical evidence to support its efficacy, BMC has limited support. This study did not prove BMC to be superior to PRP, providing guidance to clinicians treating OA. It is possible that the results were affected by patients knowing that there was no control group. Registration: NCT03289416 ( ClinicalTrials.gov identifier).

scholarly journals Functional outcomes of bone marrow aspirate concentrate application in osteoarthritis of the knee

2019 ◽  
Vol 7 (2) ◽  
pp. 587
Author(s):  
Safa Gursoy ◽  
Mustafa Akkaya ◽  
Mehmet Emin Simsek ◽  
Murat Bozkurt
Keyword(s):  
Bone Marrow ◽  
Functional Recovery ◽  
Functional Outcomes ◽  
Bone Marrow Aspirate ◽  
Osteoarthritis Of The Knee ◽  
Bone Marrow Aspirate Concentrate ◽  
Symptomatic Knee ◽  
Significant Difference ◽  
The Mean

Background: Osteoarthritis (OA) of the knee is a very common musculoskeletal disorder. Although total knee replacement is a suitable option in the treatment of severe OA, it has some limitations when performed in the early stage and early age. Bone marrow aspirate concentrate (BMAC), which is rich in mesenchymal stem cells, is promising due to its potentially regenerative and symptomatic effects in many disorders of the musculoskeletal system. This study aims to investigate the efficacy of BMAC in terms of functional recovery in OA of the knee joint.Methods: Total of 52 patients with unilateral symptomatic knee OA but no inflammatory disease, advanced malalignment or instability were enrolled in this study. Bone marrow aspirate was collected from the iliac crest in one session, prepared using a manufactured kit and the patients received intra-articular injections of this BMAC. The mean age of the patients was 59.2±7.4 and the mean follow-up period was 22.1±3.6 months. Functional outcomes of the patients were evaluated using Modified Cincinnati and Tegner Lysholm scoring systems.Results: It was observed that both Lysholm and Cincinnati scores of the patients were statistically significantly higher throughout the follow-up period as compared to the period before the procedure (p=0.0001). There was no statistically significant difference in Lysholm and Cincinnati ratings between gender, side and body mass index groups throughout the follow-up period (p >0.05). It was found that the results of the patients with Kellgren-Lawrence Grade 4 severe joint arthrosis were statistically significantly lower (p <0.05).Conclusions: Considering the functional outcomes of the patients up to two years, it was observed that the application of concentrated bone marrow aspirate provided functional recovery in arthrosis of the knee joint.

scholarly journals Bone Marrow Aspirate Concentrate Is More Effective Than Hyaluronic Acid and Autologous Conditioned Serum in the Treatment of Knee Osteoarthritis: A Retrospective Study of 505 Consecutive Patients

2021 ◽  
Vol 11 (7) ◽  
pp. 2932
Author(s):  
Mohsen Hussein ◽  
Carola F. van Eck ◽  
Nevenka Kregar Velikonja
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Degenerative Changes ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Autologous Conditioned Serum ◽  
Symptomatic Knee ◽  
Comparative Clinical Study

The aim of this study was to evaluate and compare the effectiveness of three different intra-articular injective treatments: hyaluronic acid (HA), autologous conditioned serum (ACS) and bone marrow aspirate concentrate (BMAC) for the treatment of knee osteoarthritis (OA). A Level III retrospective comparative clinical study was performed on 505 consecutive patients treated with HA (n = 171), ACS (n = 222) or BMAC (n = 112) for knee OA. The mean patient age was 52 ± 13 years; 54.5% were males. Collected data included patient demographics, symptoms, visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and radiographic classification of osteoarthritis grade using plain radiographs and advanced imaging. Clinical outcome was assessed at 3 and 12 months post treatment. Significant improvement in VAS and WOMAC was seen for all three treatments at the 3-month follow-up. At 12 months, VAS was improved in all three treatment groups, yet only BMAC sustained the improved WOMAC even in patients with more severe degenerative changes. This study shows that BMAC is more effective than HA and ACS in the treatment of symptomatic knee OA, especially in the patients with more severe degenerative changes.

scholarly journals BMAC and Adipose-Derived MSCs Treatment for Knee Osteoarthritis: A Systematic Review

2021 ◽  
Vol 7 (04) ◽  
pp. 01-11
Author(s):  
Pooja Pithadia
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Stromal Vascular Fraction ◽  
Cochrane Library ◽  
Bone Marrow Aspirate Concentrate ◽  
Mesh Terms

Background: Knee osteoarthritis is the most common musculoskeletal progressive disorder that affects nearly 303 million people worldwide. This condition prevails in 10% males and 13% females among the elders above 60. Although there is conventional nonsurgical and surgical treatment available for knee osteoarthritis, there is a fascinating interest in bone marrow aspirate concentrate (BMAC) as well as adipose-derived mesenchymal stem cells (AD-MSC), including enzymatically treated stromal vascular fraction (SVF) and mechanically treated (microfat/nanofat) injections among physicians. Hence, this systematic review aims to determine the efficacy of BMAC and AD-MSCs (enzyme and mechanically treated) injections for knee osteoarthritis treatment. Methods: A systematic review was performed on the following data sources (PubMed, Scopus, Google Scholar, EMBASE, and Cochrane Library) published on March 31, 2021. The keywords or MeSH terms include 'Knee Osteoarthritis with 'Bone marrow aspirate concentrate' OR 'BMAC' or with 'Adipose-derived mesenchymal stem cells (AD-MSC)' or with 'Stromal vascular fraction' OR 'SVF' or 'Mechanically treated AD-MSC (mfat/nanofat)'. In addition, the retrieved articles were further reviewed to identify relevant research studies. Results: The authors reviewed and tabulated data based on the year of study, study type, therapy protocol, patient population, outcome measures, and interpretation. Among the 382 records screened, 43 studies (16 on BMAC and 27 on AD-MSCs) were included in the systematic review study. Among them, only 5 were randomized controlled trials. These selected studies demonstrated short-term positive outcomes such as improvement in knee pain and function with no adverse side effects. Moreover, researchers reported varied administration methods of BMAC or AD-MSC either as standalone or in combination with other conservative procedures such as PRP (Platelets Rich Plasma), HA (Hyaluronic acid), or surgery. Conclusions: BMAC and AD-MSC (enzymatically and mechanically treated) injections prove safer and more efficacious in patients with knee osteoarthritis for a shorter duration of 2 years. However, the available literature lacks high-quality studies with no varied clinical settings and long-term follow-up of more than two years.

scholarly journals Patient-Reported Outcomes After Platelet-Rich Plasma, Bone Marrow Aspirate, and Adipose-Derived Mesenchymal Stem Cell Injections for Symptomatic Knee Osteoarthritis

2020 ◽  
Vol 13 ◽  
pp. 117954412093108
Author(s):  
Esteban Estrada ◽  
Jose L Décima ◽  
Marcelo Rodríguez ◽  
Marianela Di Tomaso ◽  
Javier Roberti
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Mesenchymal Stem Cell ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Functional Score ◽  
Treatment Groups ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

Objective: The objective of this study was to compare platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and adipose-derived mesenchymal stem cell (MSC) injections in the treatment of osteoarthritis (OA) of the knee using functional scores. Methods: A total of 89 patients with painful knee OA were included in this study. Patients were assigned to one of the 3 treatments according to severity of OA as indicated by symptoms and radiography to PRP (stage I), BMAC (stage II), or adipose-derived MSC (stage III). Clinical assessment was performed using the Knee Society Score, which combines the Knee Score, based on the clinical parameters, and the Functional Score, and IKDC score. Surveys were completed at preoperative and at 90, 180, and 265 days postoperative. The follow-up responses were compared with baseline and between treatment groups. Results: Treatment with PRP, BMAC, and adipose-derived MSC included 29 (32.6%), 27 (30.3%), and 33 (37.1%) patients, respectively. For the total group, median age was 61 years (range: 22-84 years). Score values were comparable among treatment groups at baseline. Statistically significant improvement was observed in the 3 groups according to the 3 scores at all time points during follow-up compared with baseline. No difference was found among treatment type. Conclusions: Our findings support previous reports and encourage further research on the use of these cost-effective treatments for OA of the knee.

Knee osteoarthritis risk in non-industrial societies undergoing an energy balance transition: evidence from the indigenous Tarahumara of Mexico

2019 ◽  
Vol 78 (12) ◽  
pp. 1693-1698 ◽  
Author(s):  
Ian J Wallace ◽  
David T Felson ◽  
Steven Worthington ◽  
Jeffrey Duryea ◽  
Margaret Clancy ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Energy Balance ◽  
Knee Osteoarthritis ◽  
Lifestyle Changes ◽  
Positive Energy ◽  
Abdominal Adipose Tissue ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Positive Energy Balance ◽  
Industrial Societies

Non-industrial societies with low energy balance levels are expected to be less vulnerable than industrial societies to diseases associated with obesity including knee osteoarthritis. However, as non-industrial societies undergo rapid lifestyle changes that promote positive energy balance, individuals whose metabolisms are adapted to energetic scarcity are encountering greater energy abundance, increasing their propensity to accumulate abdominal adipose tissue and thus potentially their sensitivity to obesity-related diseases.ObjectivesHere, we propose that knee osteoarthritis is one such disease for which susceptibility is amplified by this energy balance transition.MethodsSupport for our hypothesis comes from comparisons of knee radiographs, knee pain and anthropometry among men aged ≥40 years in two populations: Tarahumara subsistence farmers in Mexico undergoing the energy balance transition and urban Americans from Framingham, Massachusetts.ResultsWe show that despite having markedly lower obesity levels than the Americans, the Tarahumara appear predisposed to accrue greater abdominal adiposity (ie, larger abdomens) for a given body weight, and are more vulnerable to radiographic and symptomatic knee osteoarthritis at lower levels of body mass index. Also, proportionate increases in abdomen size in the two groups are associated with greater increases in radiographic knee osteoarthritis risk among the Tarahumara than the Americans, implying that the abdominal adipose tissue of the Tarahumara is a more potent stimulus for knee degeneration.ConclusionsHeightened vulnerability to knee osteoarthritis among non-industrial societies experiencing rapid lifestyle changes is a concern that warrants further investigation since such groups represent a large but understudied fraction of the global population.

Sign in / Sign up

Export Citation Format

Share Document