A single dose of bone marrow mononuclear cells (BMMNCs) and bone marrow aspirate concentrate (BMAC) for the treatment of knee OA. First 6 months of follow up.

Abstract

Background & Aim Autologous mesenchymal stem cells have been utilized to treat degenerative orthopedic conditions for more than two decades. The intra-articular injection of the Bone Marrow Mononuclear Cells (BMMNCS) seems to be a safe manipulation for the treatment of Knee Osteoarthritis (Knee OA). Also, Bone Marrow Aspirate Concentrate (BMAC) is one of the best options in USA. The aim of this study is to evaluate safe and effectiveness of a single dose from a double concentration of Autologous Stem Cell Product. Methods, Results & Conclusion This is a level I, prospective, descriptive study, between January and June 2018. 21 patients, range: 55-88 years, with knee OA Kellgren Lawrence (K-L) grade III and IV received one intra-articular injection of BMMNCs and BMAC in a same syringe (8ml) in a medium dose of 1.26 × 10 (9)/ml Mononuclear Cells and 650.000/ml Platelets. The main symptoms of knee osteoarthritis and tissue structure changes were evaluated after 6 months comparing the Visual Analogue Score (VAS) and Knee Injury and Orthopedic Outcome Score (KOOS) at different times. The initial VAS value varied between 4 and 10 with the median being equal to 8.5 in the patients. Initial KOOS varied between 13.4 and 70.1 with the median being equal to 35.7. In order to evaluate the evolution of patients with respect to their knees and associated problems, the KOOS and VAS scores were calculated at the initial time and some time later (between 1-2 months in 10 patients, between 2-3 months in 9 patients, and between 4-6 months in 10 patients). The VAS and KOOS medians were compared in each of the moments versus the initial moment. The decrease in VAS was not significant in the moments 1-2 months (p = 0.375) and 2-3 months (p = 0.202) but was in the 4-6 months (p = 0.036). The increase in KOOS was significant at all times (1-2 months: p = 0.016, 2-3 months: p = 0.004 and 4-6 months: p = 0.0016). All KOOS sub-scales were significant at 4-6 months. No adverse effects were detected.