scholarly journals Bone marrow aspirate concentrate versus platelet-rich plasma for treating knee osteoarthritis: a one-year non-randomized retrospective comparative study

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Abed El-Hakim El-Kadiry ◽  
Carlos Lumbao ◽  
Natasha Salame ◽  
Moutih Rafei ◽  
Riam Shammaa
Keyword(s):  
Quality Of Life ◽  
Bone Marrow ◽  
Comparative Study ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Retrospective Comparative Study

Abstract Background Knee osteoarthritis (OA) is a debilitating condition affecting human body biomechanics and quality of life. Current standard care for knee OA leads to trivial improvement and entails multiple adverse effects or complications. Recently, investigational cell therapies injected intra-articularly, such as bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), have shown safety and therapeutic potency providing patients with pain relief. In the current retrospective comparative study, we investigated the differences in pain and functional improvements in patients with symptomatic knee OA receiving intra-articular injections of BMAC vs PRP. Methods Pain and functionality scores were measured at baseline and at different time points post-injection over 12 months, using 3 self-administered, clinically validated questionnaires: the visual analogue scale (VAS) for assessing pain intensity, the knee injury and osteoarthritis outcome score (KOOS) for evaluating functionality and knee-related quality of life, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for evaluating physical function. The repeated-measures general linear model with Sidak test for pairwise comparisons was used to investigate the influence of the treatment on the score evolution within groups (between baseline and each time point) and between groups (overall). Results The BMAC group (n = 26 knees) significantly improved in VAS, KOOS, and WOMAC scores between baseline and 12 months (57.4, 75.88, and 73.95% mean score improvement, respectively). In contrast, the PRP group (n = 13 knees) witnessed nonsignificant improvement in all scores. BMAC, in comparison to PRP, induced significant improvement in outcomes by 29.38% on the VAS scale, 53.89% on the KOOS scale, and 51.71% on the WOMAC scale (P < .002, P < .01, P < .011, respectively). Conclusions Intra-articular autologous BMAC injections are safe, effective in treating pain, and ameliorate functionality in patients with symptomatic knee OA to a greater extent than PRP injections. Graphical abstract Intra-articular autologous BMAC therapy is safe and provides more relief to patients with symptomatic knee osteoarthritis compared to PRP therapy.

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 Platelet-Rich Plasma Injections for Advanced Knee Osteoarthritis: A Prospective, Randomized, Double-Blinded Clinical Trial

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668938 ◽  
Author(s):  
Nayana Joshi Jubert ◽  
Luciano Rodríguez ◽  
Maria Mercedes Reverté-Vinaixa ◽  
Aurora Navarro
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Late Stage ◽  
Platelet Rich Plasma ◽  
Short Form ◽  
Controlled Trial ◽  
Young Patients ◽  
Knee Oa ◽  
Symptomatic Knee

Background: Intra-articular injections of platelet-rich plasma (PRP) to treat symptoms of knee osteoarthritis (OA) have been successfully used in young patients and in the early stages of disease. No previous studies have analyzed outcomes of PRP injections during the late stages. Hypothesis: PRP reduces pain and leads to a more effective and lasting functional recovery than corticosteroid with local anesthetic. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 75 patients with symptomatic knee OA (Kellgren-Lawrence grade 3 to 4) were enrolled in this study between August 2013 and July 2014. Patients were randomized to treatment either with a single leukocyte-reduced PRP or corticosteroid intra-articular injection. The primary variable was visual analog scale assessment at 1 month. Secondary outcomes were the Knee injury and Osteoarthritis Outcome Score (KOOS) and Short Form–36 (SF-36) at 1, 3, and 6 months after treatment. Patient satisfaction at final follow-up was assessed. Both groups were homogeneous and comparable in baseline characteristics. Results: All variables improved in both groups. Statistical differences between groups were not found for the majority of the outcome variables, although the magnitude of improvements tended to be greater in the PRP group. Quality-of-life differences between values at 3 and 6 months versus baseline increased significantly more in the study group ( P = .05 and .03, respectively), and so did general health perception differences at 6 months ( P = .018). Conclusion: A single PRP intra-articular injection is effective for relieving pain and improving activities of daily living and quality of life in late-stage knee OA. For patients with late-stage knee OA who are 67 years or older, 1 intra-articular injection of PRP has similar results to 1 shot of corticosteroid.

scholarly journals Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

2021 ◽  
Vol 11 (18) ◽  
pp. 8711
Author(s):  
Dalila Scaturro ◽  
Fabio Vitagliani ◽  
Pietro Terrana ◽  
Daniele Cuntrera ◽  
Vincenzo Falco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Disease Severity ◽  
Prospective Trial ◽  
Open Label ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Significant Difference

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA.

scholarly journals Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1193
Author(s):  
Oliver Dulic ◽  
Predrag Rasovic ◽  
Ivica Lalic ◽  
Vaso Kecojevic ◽  
Gordan Gavrilovic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Side Effects ◽  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Grade Ii

Background: In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare clinical outcomes of knee injections of Bone Marrow Aspirate Concentrate (BMAC), Platelet-rich Plasma (PRP), or Hyaluronic acid (HA) in the OA treatment. Methods: Patients with knee pain and osteoarthritis KL grade II to IV were randomized to receive a BMAC, PRP, and HA injection in the knee. VAS, WOMAC, KOOS, and IKDC scores were used to establish baseline values at 1, 3, 6, 9, and 12 months. All side effects were reported. Results: A total of 175 patients with a knee osteoarthritis KL grade II-IV were randomized; 111 were treated with BMAC injection, 30 with HA injection, and 34 patients with PRP injection. There were no differences between these groups when considering KL grade, BMI, age, or gender. There were no serious side effects. The mean VAS scores after 3, 7, 14, and 21 days showed significant differences between groups with a drop of VAS in all groups but with a difference in the BMAC group in comparison to other groups (p < 0.001). There were high statistically significant differences between baseline scores and those after 12 months (p < 0.001) in WOMAC, KOOS, KOOS pain, and IKDC scores, and in addition, there were differences between these scores in the BMAC group in comparison with other groups, except for the PRP group in WOMAC and the partial IKDC score. There were no differences between the HA and PRP groups, although PRP showed a higher level of clinical improvement. Conclusions: Bone marrow aspirate concentrate, Leukocyte rich Platelet Rich Plasma, and Hyaluronic acid injections are safe therapeutic options for knee OA and provide positive clinical outcomes after 12 months in comparison with findings preceding the intervention. BMAC could be better in terms of clinical improvements in the treatment of knee OA than PRP and HA up to 12 months. PRP provides better outcomes than HA during the observation period, but these results are not statistically significant. More randomized controlled trials and high quality comparative studies are needed for direct correlative conclusions.

scholarly journals The Effect of Combined Bone Marrow Aspirate, Lipoaspirate, and Platelet Rich Plasma Injections on Pain, Function, and Perceived Change Amongst Individuals with Severe Knee Osteoarthritis

2021 ◽  
Vol 3 (1) ◽  
pp. e29-e39
Author(s):  
Morey Kolber ◽  
Joseph Purita ◽  
Jose Fabio Santos Duarte Lana ◽  
Paul Salamh ◽  
William Hanney
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Fat Graft ◽  
Patient Specific ◽  
Initial Visit ◽  
Minimally Processed ◽  
Knee Oa ◽  
Chi Square Analysis

Background: Owing to a paucity of research on minimally processed orthobiologics, we sought to investi-gate the efficacy of minimally processed bone marrow aspirate (BMA) and fat graft with a leukocyte-rich, platelet-rich plasma (PRP) intra-articular injection series on pain, function, and global rating of change (GROC) among patients with severe knee osteoarthritis (OA).Methods: Thirty-one adults (23 females and 8 males, mean age 67 years) with clinical and radiographic evidence of knee OA (Kellgren–Lawrence ≥ 3) were included. During the initial visit, patients were exam-ined and administered the patient-specific functional scale (PSFS) and a numerical pain rating scale ranging from 0 to 10. Patients then underwent procedures to obtain 4–6 mL of PRP, a minimally processed 6 mL fat graft, and 10 mL of BMA. Patients returned twice over 6-week intervals for booster PRP injections. At each follow-up (F1 and F2), the GROC questionnaire and prior outcome measures were completed. Results: Patients returned at an average of 41 days for the second PRP (F1) and 90 days from initial visit for the third PRP injection (F2). Friedman Chi Square analysis indicated statistically significant improvements in pain (best and worst) and PSFS from initial to F1 and F2 (P ≤ 0.001). Post hoc Wilcoxon signed-ranks analysis with Bonferroni correction identified improvement from initial to F1 and F2, as well as F1–F2 for pain, PSFS, and GROC (P ≤ 0.013). Effect sizes ranged from r = 0.32 to 0.51. Change, based on established minimum clinically important differences, indicated pain, GROC, and PSFS met thresholds at F2. Conclusion: A minimally processed fat graft with BMA and a series of three PRP injections improved pain and function among individuals with severe knee OA who were previously recalcitrant to conservative care. Although results indicated significant improvement, clinically important change did not occur until F2. A one-arm design is a limitation of this study.

scholarly journals Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) versus Hyaluronic Acid (A one-year randomized clinical trial)

2015 ◽  
Vol 8 ◽  
pp. CMAMD.S17894 ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Seyed Mansoor Rayegani ◽  
Hossein Hassanabadi ◽  
Mohammad Fathi ◽  
Elham Ghorbani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Randomized Clinical Trial ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Knee Oa ◽  
Sf 36

Introduction Knee osteoarthritis (OA) is the most common articular disease. Different methods are used to alleviate the symptoms of patients with knee OA, including analgesics, physical therapy, exercise prescription, and intra-articular injections (glucocorticoids, hyaluronic acid [HA], etc). New studies have focused on modern therapeutic methods that stimulate cartilage healing process and improve the damage, including the use of platelet-rich plasma (PRP) as a complex of growth factors. Due to the high incidence of OA and its consequences, we decided to study the long-term effect of intraarticular injection of PRP and HA on clinical outcome and quality of life of patients with knee OA. Method This non-placebo-controlled randomized clinical trial involved 160 patients affected by knee OA, grade 1–4 of Kellgren–Lawrence scale. In the PRP group ( n = 87), two intra-articular injections at 4-week interval were applied, and in the HA group ( n = 73), three doses of intra-articular injection at 1-week interval were applied. All patients were prospectively evaluated before and at 12 months after the treatment by Western Ontario and McMaster Universities Arthritis Index (WOMAC) and SF-36 questionnaires. The results were analyzed using SPSS 16.1 software (RCT code: IRCT2014012113442N5). Results At the 12-month follow-up, WOMAC pain score and bodily pain significantly improved in both groups; however, better results were determined in the PRP group compared to the HA group ( P < 0.001). Other WOMAC and SF-36 parameters improved only in the PRP group. More improvement (but not statistically significant) was achieved in patients with grade 2 OA in both the groups. Conclusion This study suggests that PRP injection is more efficacious than HA injection in reducing symptoms and improving quality of life and is a therapeutic option in select patients with knee OA who have not responded to conventional treatment.

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.

Impact of knee osteoarthritis on the quality of life among Saudi elders: A comparative study

2013 ◽  
Vol 13 (1) ◽  
pp. 10 ◽  
Author(s):  
Abdulaziz Al-Ahaideb ◽  
AsmaSaad Alrushud ◽  
SalwaB El-Sobkey ◽  
AshrafRamadan Hafez
Keyword(s):  
Quality Of Life ◽  
Comparative Study ◽  
Knee Osteoarthritis

scholarly journals Comparative study of functional capacity and quality of life among obese and non-obese elderly people with knee osteoarthritis

2016 ◽  
Vol 56 (2) ◽  
pp. 126-130
Author(s):  
Mansueto Gomes-Neto ◽  
Anderson Delano Araujo ◽  
Isabel Dayanne Almeida Junqueira ◽  
Diego Oliveira ◽  
Alécio Brasileiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Comparative Study ◽  
Knee Osteoarthritis ◽  
Elderly People ◽  
Functional Capacity

Acute Myeloid Leukemia In Patient Over 90 Years Old: Where Do We Go From Here? Case Report

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5034-5034 ◽  
Author(s):  
Marcelo Bellesso ◽  
Daniela Ferreira Dias ◽  
Renato Centrone ◽  
Rodrigo Santucci ◽  
Izabel Pernambuco Nicodemo
Keyword(s):  
Quality Of Life ◽  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Bone Marrow Aspirate ◽  
Chronological Age ◽  
Acceptable Quality ◽  
Blast Cells ◽  
Acute Myeloid

Abstract Introduction Acute Myeloid Leukemia (AML) widely affects elderly patients, with disappointing survival rates with increasing age. Although chronological age is an independent prognostic risk, it is really important to understand that this group is heterogeneous, so a geriatric assessment may be helpful before making decisions regarding therapy. We describe a 91 year-old patient with AML treated with decitabine, achieving a complete response and good quality of life for 10 months. Case Report In May 2012, a 91 year-old woman with myelodysplastic syndrome was admitted at the emergency department presenting asthenia, pallor, pain and edema of the left inferior limb. Her blood count showed: hemoglobin 10.7g/dL, leukocytes 81.800/mm³ with 95% blast cells, and platelets 45.000/mm³. In addition, a Doppler ultrasound evidenced deep venous thrombosis in her left leg. A bone marrow aspirate confirmed AML with myelodysplasia-related alterations, with 95% blast cells, with positive expression of CD45, CD33, MPO, and CD117 (CD45+; CD33+; MPO+; CD117+). Her karyotype was 46,XX [20 cells analyzed]. She was first treated with hydroxyurea. Afterwards, as her performance status improved and in spite of her age, we decided to treat her with Decitabine 20mg/m²/day for 5 days, because she had no severe comorbidity or any severe impairment of every-day-life instrumental activities. After a first cycle with grade 4 neutropenia and thrombocytopenia, she was discharged. After 40 days, complete hematologic recovery was observed. She received seven treatment cycles, and the most important symptom of toxicity was febrile grade 3 neutropenia in the 3rd cycle, with the only inpatient treatment. After this intercurrence, the doses were reduced by 25%. The patient achieved complete remission, spent eleven months without needing blood transfusions and with an acceptable quality of life, but then she relapsed, presenting persistent neutropenia and 44% of blasts in a bone marrow aspirate (05/27/2013). She died on 07/02/2013 due to the progression of the disease. Conclusion This case shows that, despite her advanced chronological age, our patient, affected by a fatal disease, lived approximately 13 months with optimal response to treatment (with Decitabine) and enjoying an acceptable quality of life for ten months. Considering this patient profile, could we conclude that this outcome is the best our treatment can aim to achieve? Disclosures: No relevant conflicts of interest to declare.

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