scholarly journals Laser Needling® and Natural origin, Highly Purifi ed Polynucleotides (PN-HPT™) in Knee Osteoarthrosis: Benefi ts in Physiatry and Sports Medicine

2020 ◽  
Vol 4 (2) ◽  
pp. 030-037
Author(s):  
Maria Conforti
Keyword(s):  
Knee Osteoarthritis ◽  
Real Life ◽  
Treatment Protocol ◽  
Low Energy ◽  
Ultrasound Guided ◽  
Laser Technique ◽  
Laser Device ◽  
Short Term ◽  
Natural Origin ◽  
Knee Oa

Background and Objectives: The purpose of the paper is to illustrate the real life clinical outcomes of a retrospective cohort of knee Osteoarthritis (OA) patients treated with a novel laser disease management program; at the same time, to defi ne the most effective operative procedure. The new laser technique mimics the in-vitro benefi ts of Low-Level Laser Therapies (LLLT). The study compared the 3month effi cacy and 6-month persistence of clinical and functional benefi ts after application of laser energy either externally with a standard High Power Laser Therapy (HPLT) laser device (AG1 device, FP3 version), or intra-articularly with the patented, low-energy AG8 intra articular fi ber device (ultrasound-guided, same wavelengths, no handpiece). This innovative laser device reduces to one hundredth the applied energy density. The pain suppressing effi cacy of the LLLT-like laser FP3 procedure is intended to act synergically with the strong biorestructuring and pain suppressing effi cacy of natural origin polynucleotides (PN-HPT™ or Highly Purifi ed Technology™) injected before the laser session. PN-HPT™ are widely used in knee OA management for their persistent viscosupplementation properties overlapping those of high molecular weight hyaluronic acid. Trial design: retrospective comparison of:  Short term 3 month effi cacy outcomes on pain and disability  6-month persistence of clinical improvements in two cohorts of patients with severe knee osteoarthritis. The active cohort knee OA patients (105 agonistic or recreative practitioners with persistent knee pain and disability resistant to conventional medical or physical therapies) were treated with an innovative intra articular low-energy AG8 physical therapy protocol (ambulatory “AG8 Protocol 3” combined with a preliminary PN-HPT™ knee injection); the control-cohort patients (109 patients with knee disease of similar severity) were treated with a standard, multi frequency HPLT ambulatory treatment protocol (FP3 device). Outcome parameters: Western Ontario and McMaster Universities (WOMAC) assessments at baseline (T0) and after 2 weeks (T2) and 3 months (T3). Secondary parameters: Nociceptive and neuropathic pain; assessment: standard 10 cm Visual Analogue Scale (VAS) immediately before and at the end of each treatment session. Results: Treatment with the AG8 protocol 3 / PN-HPT™ intra articular combination was associated with strongly signifi cant short term (2 weeks) and medium-term (3 months) benefi ts vs. controls treated with a conventional FP3 extra-articular treatment protocol both for the WOMAC Total Score and WOMAC Pain and Function subscores. Benefi ts for the WOMAC Stiffness subscore were borderline non-signifi cant. The subgroup analysis showed that the 2A (Grade-2 KL primary OA) and 2B (Grade-2 KL secondary (post-surgical) OA) mainly contributed to overall benefi ts. Conclusion: The study showed the intra-articular Laser Needling® technique (ultrasound-guided AG8 laser device, Protocol 3 plus infi ltration of a facilitating agent such as intra-articular PN-HPT™ gel) to be more effective on knee OA pain than the traditional extra-articular FP3 laser technique, with special reference to pain associated with primary OA.

scholarly journals Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid

2018 ◽  
Vol 1 (21;1) ◽  
pp. 41-51 ◽  
Author(s):  
Woo-Jong Choi
Keyword(s):  
Knee Osteoarthritis ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Oxford Knee Score ◽  
Rf Ablation ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Short Term ◽  
Knee Oa

Background: Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial. Objectives: The current study aims to assess the effects of combining corticosteroids and local anesthesia during ultrasound-guided GNB in patients with chronic knee OA. Study Design: A randomized, double-blinded institutional study. Setting: This study took place at Asan Medical Center in Seoul, Korea. Methods: Forty-eight patients with chronic knee OA were randomly assigned to either the lidocaine alone group (n = 24) or lidocaine plus triamcinolone (TA) group (n = 24) before ultrasound-guided GNB. Visual analog scale (VAS), Oxford Knee Score (OKS), and global perceived effects (7-point scale) were assessed at baseline and at 1, 2, 4, and 8 weeks after the procedure. Results: The VAS scores were significantly lower in the lidocaine plus TA group than in the lidocaine alone group at both 2 (P < 0.001) and 4 (P < 0.001) weeks after GNB. The alleviation of intense pain in the lidocaine plus TA group was sustained up to 2 weeks after the procedure, in accordance with the definition of a minimal clinically important improvement. Although a similar intergroup difference in OKSs was observed at 4 weeks (P < 0.001), the clinical improvement in functional capacity lasted for only one week after the reassessment of OKSs, in accordance with a minimal important change. No patient reported any postprocedural adverse events during the follow-up period. Limitations: The emotional state of the patients, which might affect the perception of knee pain, was not evaluated. The follow-up period was 2 months; this period might be insufficient to validate the short-term effects of GNB. Conclusions: Ultrasound-guided GNB, when combined with a local anesthetic and corticosteroid, can provide short-term pain relief. However, the clinical benefit of corticosteroid administration was not clear in comparison with local anesthesia alone. Given the potential adverse effects, corticosteroids might not be appropriate as adjuvants during a GNB for chronic knee OA. The study protocol was approved by our institutional review board (2012-0210), and written informed consent was obtained from all patients. The trial was registered with the Clinical Research Information Service (KCT 0001139). Key words: Chronic pain, knee osteoarthritis, genicular nerve block, ultrasound, corticosteroid, local anesthetic, visual analog scale, Oxford Knee Score

scholarly journals FRI0382 EFFECTS OF GENICULAR NERVE BLOCK IN PATIENTS WITH KNEE OSTEOARTHRITIS WHO HAVE NEUROPATHIC OR NOCICEPTIVE PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 788.2-789
Author(s):  
B. Tas ◽  
P. Akpinar ◽  
I. Aktas ◽  
F. Unlu Ozkan ◽  
I. B. Kurucu
Keyword(s):  
Neuropathic Pain ◽  
Knee Osteoarthritis ◽  
Nerve Block ◽  
Intractable Pain ◽  
Ultrasound Guided ◽  
Lidocaine Group ◽  
Knee Oa ◽  
Significant Difference ◽  
Genicular Artery ◽  
Saline Solutions

Background:Genicular nerve block (GNB) is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA)(1). There is increasing support for the neuropathic component to the knee OA pain. Investigators proposed that targeting treatment to the underlying pain mechanism can improve pain management in knee OA (2). There is a debate on injectable solutions used in nerve blocks (3).Objectives:To investigate the analgesic and functional effects of USG-guided GNB in patients with chronic knee OA (with/without neuropathic pain) and to evaluate the efficacy of the anesthetic and non-anesthetic solutions used.Methods:Ninety patients with chronic knee OA between the ages of 50-80 were divided into two groups with and without neuropathic pain according to painDETECT questionnaire (4). The groups were randomized into three subgroups to either the lidocaine group (n=30) or dextrose group (n=29) or saline solutions (n=31). After the ultrasound-guided GNB, quadriceps isometric strengthening exercises and cryotherapy were recommended to the patients. Visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne-algofunctional Index were assessed at baseline and at 1 week, 1 and 3 months later after the procedure.Results:Statistically significant improvement was observed in all groups with or without neuropathic pain according to VAS values at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05). Statistically significant improvement was observed in all groups with neuropathic pain according to painDETECT values at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05). There was a statistically significant improvement in the groups without neuropathic pain which received dextrose and saline solutions, according to painDETECT values, but not in the group which received lidocain at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p>0.05). There was a statistically significant improvement in all groups with or without neuropathic pain according to WOMAC and Lequesne total scores at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05).Conclusion:We conclude that in patients with chronic knee OA (with/without neuropathic pain), the use of GNB with USG is an analgesic method which provides short to medium term analgesia and functional recovery and has no serious side effects. The lack of significant difference between the anesthetic and non-anesthetic solutions used in the GNB suggests that this may be a central effect rather than a symptom of peripheral nerve dysfunction. It suggests that injection may have an indirect effect through nociceptive processing and changes in neuroplastic mechanisms in the brain. In addition, we can say that regular exercise program contributes to improved physical function with the decrease in pain.References:[1]Kim DH et al. Ultrasound-guided genicular nerve block for knee osteoarthritis: a double-blind, randomized controlled trial of local anesthetic alone or in combination with corticosteroid. Pain Physician 2018;21:41-51.[2]Thakur M et.al. Osteoarthritis pain: nociceptive or neuropathic?. Nat Rev Rheumatol 2014:10(6):374.[3]Lam SKH et al. Transition from deep regional blocks toward deep nerve hydrodissection in the upper body and torso: method description and results from a retrospective chart review. BioMed Research International Volume 2017;7920438.[4]Hochman JR et al. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage. 2011 Jun;19(6):647-54.Fig. 1:Ultrasound- guided identification of GNB target sites. Doppler mode. White arrows indicate genicular arteries.A.Superior medial genicular artery.B.Inferior medial genicular artery.C.Superior lateral genicular artery.Disclosure of Interests:None declared

scholarly journals A Double-Blind, Active-Controlled Clinical Trial of Sodium Bicarbonate and Calcium Gluconate in the Treatment of Bilateral Osteoarthritis of the Knee

2017 ◽  
Vol 10 ◽  
pp. 117954411668889 ◽  
Author(s):  
María del Carmen Caamaño ◽  
Sandra García-Padilla ◽  
Miguel Ángel Duarte-Vázquez ◽  
Karla Elena González-Romero ◽  
Jorge L Rosado
Keyword(s):  
Clinical Trial ◽  
Sodium Bicarbonate ◽  
Knee Osteoarthritis ◽  
Calcium Gluconate ◽  
Controlled Clinical Trial ◽  
Osteoarthritis Of The Knee ◽  
Short Term ◽  
Double Blind ◽  
Knee Oa ◽  
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

scholarly journals Intra-articular corticosteroid injection and genicular nerve block under ultrasound guidance in pain control of knee osteoarthritis

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Abdel Rahman Ragab ◽  
Sherif Hegab ◽  
Rehab Elnemr ◽  
Amr Abdel-Kerim
Keyword(s):  
Knee Osteoarthritis ◽  
Nerve Block ◽  
Corticosteroid Injection ◽  
Oxford Knee Score ◽  
The Elderly ◽  
Functional Improvement ◽  
Ultrasound Guided ◽  
Knee Oa ◽  
Group 2

Abstract Background Chronic knee osteoarthritis (OA) is a frequent disease among the elderly. Intra-articular corticosteroid injection (IACSI) was commonly adopted to alleviate knee OA-related pains. Recently, Genicular nerve block (GNB) has emerged as a new alternative technique. The current study aimed to investigate the efficacy of those two approaches when guided with ultrasound and to determine which one offers better results. This study included 40 patients with painful chronic knee OA (Nine males and 31 females, age ranged from 44 to 65 years) and were randomly assigned to two equal groups. Groups 1 was managed with ultrasound-guided IACSI and group 2 with ultrasound-guided GNB using a mixture of lidocaine and Triamcinolone Acetonide. The baseline mean visual analogue scale (VAS) and Oxford knee score (OKS) for the group 1 were 87.10 and 51.3, while for group 2 were 87.75 and 53.25 respectively. Follow up values were obtained at 2, 4 and 8 weeks using VAS and OKS. Results The VAS score and OKS score were significantly lower in the GNB group and IACSI group at 2, and 4 weeks after the procedure (p < 0.001 for all), then returned near baseline values at 8 weeks. When the two groups were compared according to changes in VAS and OKS from baseline at 2, 4, and 8 weeks, GNB group showed significant alleviation of pain (mean reduction of 58.5, 53.3, and 9.25 points at 2, 4, and 8 weeks versus 44.9, 39.4, and 5.6 points at the IACSI groups, p < 0.001 at 2 and 4 weeks, p < 0.006 at 8 weeks). Similarly at the OKS, the GNB group showed significantly better results (33.50, 28.60, and 8.5 at GNB and 26.45, 20.10, 5.25 at IACSI. p < 0.001 at all periods). Conclusions Both GNB and IACSI are effective methods to relieve chronic knee osteoarthritis-related pains. When compared to each other, GNB showed more significant pain relief and functional improvement than IACSI.

scholarly journals Transcranial magnetic stimulation associated with manual therapy in patients with knee osteoarthritis: a randomized controlled clinical trial protocol

2020 ◽  
pp. 1-4
Author(s):  
Mannaly Mendonça ◽  
Maria das Graças Araújo ◽  
Camilla Fonseca ◽  
Maíra Lima, Luiz Mèlo ◽  
Sérgio Rocha ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Transcranial Magnetic Stimulation ◽  
Knee Osteoarthritis ◽  
Manual Therapy ◽  
Magnetic Stimulation ◽  
Treatment Protocol ◽  
Controlled Clinical Trial ◽  
Knee Oa ◽  
Before And After ◽  
Registration Number

Background: Persistent pain in knee osteoarthritis (KOA) may generate sensitization of the afferent and central nervous system (CNS) pathways over time. Therefore, for patients with chronic pain derived from KOA, to associate therapies that address peripheral impairment, such as central and manual therapy and transcranial magnetic stimulation seems to be a promising strategy for pain reduction. Objectives: The purpose of this study is to unite rTMS and TM to control the pain of patients with knee OA and to examine the efficacy of this treatment protocol, assuming that this union would be more beneficial than the formally applied therapies isolated. Methods: This clinical trial with three arms interventions, controlled, triple blind and randomized, will allocate patients with KOA in groups (i) transcranial magnetic stimulation; (ii) sham transcranial magnetic stimulation + manual therapy and (iii) transcranial magnetic stimulation + manual therapy. Pain assessment will be performed using the visual analog scale of pain of 100 points, before and after the interventions, and for a maximum of 30 days after the single session. This session will involve the application of real or fictitious transcranial magnetic stimulation followed by manual or home therapy. Discussion: The study is in the recruitment stage and it is expected that after the application of the therapeutic protocol the group that performed the association has a more significant improvement in comparison to the others. Study registry: The protocol of this study was published on the Clinical Trials (www.clinicaltrials.org), with the registration number NCT03076294.

scholarly journals POS1099 EFFICACY OF INTRA-ARTICULAR CORTICOSTEROID INJECTIONS IN KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 829.2-830
Author(s):  
A. Najm ◽  
A. Alunno ◽  
C. Weill ◽  
J. Gwinnutt ◽  
F. Berenbaum
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Medium Term ◽  
Short Term ◽  
Knee Oa ◽  
Randomized Controlled ◽  
And Function

Background:Knee osteoarthritis (OA) is a frequent degenerative disease representing an important health and economic burden. Symptomatic medical treatments available include intra-articular (IA) injections of corticosteroids (GC) but their efficacy is debated. In addition, safety signals regarding cartilage damage with IA GC have been highlighted in a few studies.Objectives:To perform a meta-analysis of studies assessing IA GC efficacy and safety in knee OA.Methods:A systematic literature review and a meta-analysis of randomized controlled trials (RCTs) assessing the effect of GC IA injections versus other interventions (IA Hyaluronic Acid, IA placebo, IA NSAID, oral NSAID or physiotherapy) in knee OA was performed. The effect of the interventions on pain and function were extracted from the single studies and pooled and are presented as short term (<6weeks), medium term (6-24 weeks) and long term (>24 weeks) follow-up period. Standardized mean differences (SMD) are reported.Results:Of 520 studies screened, 23 were included in the SLR and 14 subsequently included in the MA. While IA GC showed a superior effect compared to control on both pain (SMD -0.61 (95% CI -1,25, 0.03)) and function (SMD -1.02 (95% CI -2.14, 0.10)) in short term follow-up; long term follow-up analysis favored controls (IA HA, IA NSAID, physiotherapy) for both pain (SMD 0.68 (95% CI -0.11, 1.47)) and function (SMD 0.88 (95% CI -0.36, 2.12) outcomes (Figure 1). No difference was found between interventions in the medium term. Safety data were reported in 18/23 studies (n= 1936/2314 patients); and side effects were reported as follows: arthralgia (69 IA GC patients, 146 IA HA patients, and 20 saline patients); site injection pain (7 in the IA GC group, 2 in the IA saline group, 14 in the IA HA group); 16 post injection knee swelling without signs of septic arthritis in the IA GC group and 24 in the IA HA group. In one study assessing cartilage effects of GCs, the rate of cartilage loss was greater in the GC group with a reduction of cartilage thickness at 2 year compared to placebo group. No difference was observed in the progression of cartilage denudation or bone marrow lesion. On the contrary, another study showed no effect of injections on the cartilage structure.Conclusion:We demonstrate in this work that IA GC injections reduce pain and improve function in the early phase (≤6 weeks) of treatment. In the long term (≥24 weeks), other intervention such as IA HA injections or physiotherapy seem to be more efficient, but this effect was largely driven by single studies with large effect sizes and the comparators were heterogeneous.Figure 1.Knee pain outcome at short term (≤6weeks) (A), medium term (>6 & <24 weeks) (B), and long term (≥24 weeks) (C) follow up.Disclosure of Interests:None declared.

scholarly journals The Influence of Adipose-derived Stromal Vascular Fraction Cells on the Treatment of Knee Osteoarthritis

2020 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Matsumoto ◽  
Satoshi Sobajima ◽  
Takehiko Matsushita ◽  
Hideki Iwaguro ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
T2 Mapping ◽  
Stromal Vascular Fraction ◽  
Short Term ◽  
Cell Injection ◽  
Knee Oa ◽  
Ankle Angle ◽  
The Mean ◽  
Hip Knee Ankle Angle ◽  
Better Than

Abstract Background Adipose-derived stromal vascular fraction (SVF) cells are a mixed cell population that includes cells with multilineage potential, similar to bone marrow-derived mesenchymal stem cells. Our purpose is to investigate the influence of SVF cells in patients with knee osteoarthritis (OA) and the short-term treatment effects. Methods Fifty-seven patients were enrolled and treated with intra-articular injection of 5.0×10 7 SVF cells into the knee joint between September 2017 and March 2018. All patients were followed up for 12 months or longer. Mean age at treatment and follow-up period were 69.4±6.9 years and 13.7±2.0 months, respectively. The mean preoperative hip-knee-ankle angle was 6.7±3.6°. SVF cells were prepared using the Celution®800/CRS system from the patients’ abdominal or breech subcutaneous fat. The mean SVF cell viability was 90.6±2.7%. Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the hip-knee-ankle angle assessed via radiography, and T2 mapping value using a 3.0-T magnetic resonance imaging unit were also assessed. Both clinical and imaging evaluations were performed preoperatively, 1, 3, 6, and 12 months postoperatively, and compared among all timepoints (p<0.05). Results Knee extension angle at 6 and 12 months postoperatively was significantly better than the preoperative angle. Total WOMAC, VAS, and KOOS scores at 1, 3, 6 and 12 months postoperatively were significantly better than preoperative scores. There was no significant difference in hip-knee-ankle angle among the five time periods. T2 mapping values of lateral femur and tibia were significantly higher 12 months postoperatively than preoperatively. Conclusions The short-term clinical effects of intra-articular SVF cell injection on knee OA were excellent. Intra-articular SVF cell injection is a novel and innovative approach for treating patients with knee OA.

scholarly journals The Influence of Adipose-derived Stromal Vascular Fraction Cells on the Treatment of Knee Osteoarthritis

2020 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Matsumoto ◽  
Satoshi Sobajima ◽  
Takehiko Matsushita ◽  
Hideki Iwaguro ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
T2 Mapping ◽  
Stromal Vascular Fraction ◽  
Clinical Effects ◽  
Short Term ◽  
Cell Injection ◽  
Knee Oa ◽  
Significant Difference ◽  
The Mean ◽  
Better Than

Abstract Background Adipose-derived stromal vascular fraction (SVF) cells are a mixed cell population that includes cells with multilineage potential, similar to bone marrow-derived mesenchymal stem cells. Our purpose is to investigate the influence of SVF cells in patients with knee osteoarthritis (OA) and the short-term treatment effects. Methods Fifty-seven patients were enrolled and treated with intra-articular injection of 5.0×10 7 SVF cells into the knee joint between September 2017 and March 2018. All patients were followed up for 12 months or longer. Mean age at treatment and follow-up period were 69.4±6.9 years and 13.7±2.0 months, respectively. The mean preoperative HKA angle was 6.7±3.6°. SVF cells were prepared using the Celution®800/CRS system from the patients’ abdominal or breech subcutaneous fat. The mean SVF cell viability was 90.6±2.7%. Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the HKA angle assessed via radiography, and T2 mapping value using a 3.0-T magnetic resonance imaging unit were also assessed. Both clinical and imaging evaluations were performed preoperatively, 1, 3, 6, and 12 months postoperatively, and compared among all timepoints (p<0.05). Results Knee extension angle at 6 and 12 months postoperatively was significantly better than the preoperative angle. Total WOMAC, VAS, and KOOS scores at 1, 3, 6 and 12 months postoperatively were significantly better than preoperative scores. There was no significant difference in HKA angle among the five time periods. T2 mapping values of lateral femur and tibia were significantly higher 12 months postoperatively than preoperatively. Conclusions The short-term clinical effects of intra-articular SVF cell injection on knee OA were excellent. Intra-articular SVF cell injection is a novel and innovative approach for treating patients with knee OA.

scholarly journals AB0878 THE COMPARISON EFFECTS OF INTRA-ARTICULAR INJECTION OF PLATELET RICH PLASMA (PRP), PLASMA RICH IN GROWTH FACTOR (PRGF), HYALURONIC ACID (HA), AND OZONE IN KNEE OSTEOARTHRITIS; A ONE YEAR RANDOMIZED CLINICAL TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1744.3-1745
Author(s):  
S. A. Raeissadat ◽  
P. Ghazi Hosseini ◽  
M. H. Bahrami ◽  
R. Salman Roghani ◽  
M. Fathi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Knee Osteoarthritis ◽  
Randomized Clinical Trial ◽  
Platelet Rich Plasma ◽  
Therapeutic Effects ◽  
Short Term ◽  
Knee Oa ◽  
The Mean

Background:Knee osteoarthritis (OA) as a common progressive degenerative condition is one of the most important leading causes of disability and relative dependence. Worldwide prevalence of symptomatic knee OA has estimated 3.8%. It affects more than 20% of over 45-year-old population. Among the minimally invasive methods recommended for knee OA management is intra-articular injections for which a large array of products have been used. Despite all the existing options, there is still no general consensus on the choice and priority of the best intra-articular injection in knee osteoarthritis.Objectives:Our study compare the short and long-term efficacy of the intra articular injections (IAIs) of hyaluronic acid (HA), platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), and ozone in patients with knee osteoarthritis (OA).Methods:In this single-blinded randomized clinical trial, 238 patients with mild to moderate knee OA were randomized into4 groups of IAIs: HA (3 doses weekly), PRP (2 doses with 3 weeks interval), PRGF (2 doses with 3 weeks interval), and Ozone (3 doses weekly). Our outcome measures were the mean changes from baseline until 2,6, and 12 months post intervention in scores of visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne index.Results:A total of 200 patients enrolled final analysis. The mean age of patients was 56.9 ± 6.3 years, and69.5% were women. In 2 months follow up, significant improvement of pain, stiffness, and function were seen in all groups compared to the baseline, but the ozone group had the best results(P<0.05). In 6 month follow up HA, PRP, and PRGF groups demonstrated better therapeutic effects in all scores in comparison with ozone (P<0.05).At the end of the 12th month, only PRGF and PRP groups had better results versus HA and ozone groups in all scores (P<0.05).Despite the fact that ozone showed better early results, its effects begin to wear off earlier than other products and ultimately disappear in 12 months.Conclusion:Ozone injection had rapid effects and better short-term results after 2 months, but its therapeutic effects did not persist after 6 months and at the 6-month follow up, PRP,PRGF and HA were superior to ozone. Only patients in PRP and PRGF groups improved symptoms persisted for 12 months. Therefore, these products could be the preferable choices for long-term management.References:[1]Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cuscó X, Garcia-Balletbó M. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Archives of orthopaedic and trauma surgery. 2011;131(3):311-7.[2]De La Mata J. Platelet rich plasma.A new treatment tool for the rheumatologist?ReumatologíaClínica (English Edition). 2013;9(3):166-71.[3]Raeissadat SA, Rayegani SM, Sedighipour L, Bossaghzade Z, Abdollahzadeh MH, Nikray R, et al. The efficacy of electromyographic biofeedback on pain, function, and maximal thickness of vastus medialis oblique muscle in patients with knee osteoarthritis: a randomized clinical trial. Journal of pain research. 2018;11:2781.[4]Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis & Rheumatism. 2008;58(1):26-35.[5]Tehrani-Banihashemi A, Davatchi F, Jamshidi AR, Faezi T, Paragomi P, Barghamdi M. Prevalence of osteoarthritis in rural areas of I ran: a WHO-ILAR COPCORD study. International journal of rheumatic diseases. 2014;17(4):384-8.[6]Rayegani SM, Raeissadat SA, Heidari S, Moradi-Joo M. Safety and effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Journal of lasers in medical sciences. 2017;8(Suppl 1):S12.Disclosure of Interests:None declared

scholarly journals Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

2021 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Matsumoto ◽  
Satoshi Sobajima ◽  
Takehiko Matsushita ◽  
Hideki Iwaguro ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Dose Group ◽  
Stromal Vascular Fraction ◽  
Cartilage Defects ◽  
High Dose ◽  
Short Term ◽  
Bone Marrow Lesions ◽  
Knee Oa ◽  
Different Doses

Abstract Background: Favorable clinical outcomes of the intra-articular injection of adipose-derived stromal vascular fraction (SVF) cells for knee osteoarthritis (OA) have been reported. This study aimed to compare the short-term clinical and imaging outcomes of different doses of SVF cells for knee OA treatment.Methods: This study included 60 patients with knee OA who underwent intra-articular injection of SVF cells. The follow-up period was at least 12 months. The envelope method was used to prospectively quasi-randomized the patients to undergo treatment with different doses of SVF cells. Thirty patients received an intra-articular injection of 2.5×107 SVF cells (low-dose group), and the remaining 30 patients received an intra-articular injection of 5.0×107 SVF cells (high-dose group). Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the hip-knee-ankle angle and magnetic resonance imaging Osteoarthritis Knee Score (MOAKS) features (bone marrow lesions, cartilage defects, osteophytes, Hoffa’s synovitis, and effusion synovitis), were also performed. All clinical and imaging evaluations were performed preoperatively and 12 months postoperatively and compared between the groups.Results: No significant differences in demographic data were found between the two groups. The knee extension angle at 12 months postoperatively was significantly higher than the preoperative angle in both groups. The total WOMAC and VAS scores at 12 months postoperatively were significantly more favorable than preoperative scores in both groups. The bone marrow lesions and Hoffa’s synovitis and effusion synovitis improved approximately 30-40% from baseline to 12 months postoperatively in both groups. However, there were no significant differences in the preoperative and postoperative results of any clinical or imaging evaluation between the two groups.Conclusions: The short-term clinical and imaging outcomes of intra-articular injection of SVF cells for knee OA were excellent, regardless of whether a low- or high-dose was administered. Intra-articular injection of SVF cells for knee OA is an innovative approach.

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