Intra-articular injection of culture-expanded mesenchymal stem cells with or without addition of platelet-rich plasma is effective in decreasing pain and symptoms in knee osteoarthritis: a controlled, double-blind clinical trial

Objective: To evaluate the effect of intra-articular injections of sodium bicarbonate with a single (SBCG1) or double dose (SBCG2) of calcium gluconate administered monthly compared with methylprednisolone (MP) for treatment of knee osteoarthritis. Methods: A 3-month, randomized, double-blind clinical trial with patients diagnosed with knee osteoarthritis (OA). The outcome variables were the Western Ontario-McMaster University Osteoarthritis Index (WOMAC) and the Lequesne functional index. Results: After 3 months, all treatments significantly improved in overall WOMAC and Lequesne scores. Mean changes (95% confidence interval) in WOMAC total score and the Lequesne index, respectively, for SBCG1 (−12.5 [−14.3, −10.7]; −9.0 [−11.4, −6.7]) and SBCG2 (−12.3 [−14.3, −10.4]; −8.9 [−10.4, −7.4]) were significantly greater than for MP (−5.0 [−7.2, −2.8]; −3.2 [−4.9, −1.5]) ( P < .001). Conclusions: Intra-articular injections of sodium bicarbonate and calcium gluconate are useful for short-term relief of OA symptoms in patients with bilateral knee osteoarthritis. Both treatments are more effective than MP injections in the reduction of knee OA symptoms. Trial Registration: Clinicaltrials.gov NCT00977444

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Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association with Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis. A Randomized Double-Blind Controlled Clinical Trial as Compared with Hyaluronic Acid.

Schmerz Nachrichten ◽

10.1007/s44180-021-0003-1 ◽

2021 ◽

Vol 21 (3) ◽

pp. 5-5

Keyword(s):

Clinical Trial ◽

Hyaluronic Acid ◽

Growth Factors ◽

Knee Osteoarthritis ◽

Clinical Efficacy ◽

Platelet Rich Plasma ◽

Controlled Clinical Trial ◽

Double Blind ◽

Plasma Injection

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Use of platelet-rich plasma in periodontal surgery—a prospective randomised double blind clinical trial

Clinical Oral Investigations ◽

10.1007/s00784-008-0223-7 ◽

2008 ◽

Vol 13 (2) ◽

pp. 179-187 ◽

Cited By ~ 30

Author(s):

L. Harnack ◽

R. H. Boedeker ◽

I. Kurtulus ◽

S. Boehm ◽

J. Gonzales ◽

...

Keyword(s):

Clinical Trial ◽

Platelet Rich Plasma ◽

Periodontal Surgery ◽

Double Blind ◽

Double Blind Clinical Trial

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Combination of Intra-Articular and Intraosseous Injections of Platelet Rich Plasma for Severe Knee Osteoarthritis: A Pilot Study

BioMed Research International ◽

10.1155/2016/4868613 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 22

Author(s):

Mikel Sánchez ◽

Diego Delgado ◽

Pello Sánchez ◽

Emma Muiños-López ◽

Bruno Paiva ◽

...

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Synovial Fluid ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Subchondral Bone ◽

Platelet Rich Plasma ◽

Joint Function ◽

Novel Approach ◽

New Strategy

The aim of this study was to assess a novel approach to treating severe knee osteoarthritis by targeting synovial membrane, superficial articular cartilage, synovial fluid, and subchondral bone by combining intra-articular injections and intraosseous infiltrations of platelet rich plasma. We explored a new strategy consisting of intraosseous infiltrations of platelet rich plasma into the subchondral bone in combination with the conventional intra-articular injection in order to tackle several knee joint tissues simultaneously. We assessed the clinical outcomes through osteoarthritis outcome score (KOOS) and the inflammatory response by quantifying mesenchymal stem cells in synovial fluid. There was a significant pain reduction in the KOOS from baseline(61.55±14.11)to week 24(74.60±19.19), after treatment(p=0.008), in the secondary outcomes (symptoms,p=0.004; ADL,p=0.022; sport/rec.,p=0.017; QOL,p=0.012), as well as VAS score (p<0.001) and Lequesne Index(p=0.008). The presence of mesenchymal stem cells in synovial fluid and colony-forming cells one week after treatment decreased substantially from7.98±8.21 MSC/μL to4.04±5.36 MSC/μL(p=0.019)and from601.75±312.30to139.19±123.61 (p=0.012), respectively. Intra-articular injections combined with intraosseous infiltrations of platelet rich plasma reduce pain and mesenchymal stem cells in synovial fluid, besides significantly improving knee joint function in patients with severe knee osteoarthritis. This trial is registered on EudraCT with the number2013-003982-32.

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Interferential current and photobiomodulation in knee osteoarthritis: A randomized, placebo-controlled, double-blind clinical trial

Clinical Rehabilitation ◽

10.1177/02692155211012004 ◽

2021 ◽

pp. 026921552110120

Author(s):

Renata Alqualo-Costa ◽

Érika Patrícia Rampazo ◽

Gustavo Ribeiro Thome ◽

Mônica Rodrigues Perracini ◽

Richard Eloin Liebano

Keyword(s):

Clinical Trial ◽

Knee Osteoarthritis ◽

Pain Intensity ◽

Rating Scale ◽

Pain Modulation ◽

Double Blind ◽

Time Points ◽

Double Blind Clinical Trial ◽

Interferential Current

Objectives: To evaluate the effects of interferential current and photobiomodulation in patients with knee osteoarthritis. Design: A randomized, placebo-controlled, double-blind clinical trial. Setting: Physiotherapy Clinic of City University of São Paulo. Subjects: A total of 184 patients with knee osteoarthritis were recruited and, of these, 168 were included and randomized into four groups with 42 each: interferential current, photobiomodulation, interferential current plus photobiomodulation or placebo groups. One hundred and sixty-four patients completed the study. Intervention: Patients received 12 sessions (three times a week) of treatment: 30 minutes of interferential current (active or placebo) followed by photobiomodulation (active or placebo). Main measures: Primary outcome: pain intensity at rest and during movement (numeric rating scale) after 12 sessions. Secondary outcomes: functional capacity (Timed Up & Go and Sit and Lift tests and Lequesne and WOMAC questionnaires), pressure pain threshold, conditioned pain modulation, and muscle strength production (isokinetic evaluation). Patients were assessed at baseline, after 12 sessions, and three and six months after the end of the treatment. Results: Interferential current plus photobiomodulation reduced pain intensity at rest and during movement compared to placebo and interferential current at all time points ( P < 0.05). Photobiomodulation reduced pain intensity at rest compared to placebo at all time points ( P < 0.05) and compared to interferential current at six months follow-up ( P < 0.05). Photobiomodulation reduced pain intensity during movement compared to placebo at six months follow-up ( P < 0.05). Conclusion: Interferential current plus photobiomodulation or isolated photobiomodulation improve pain intensity in knee osteoarthritis.

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