A single dose of Bone Marrow Mononuclear Cells (BMMNCs) and Bone Marrow Plasma Concentrate (BMPC) for the treatment of Knee OA. 12 months of follow up

Abstract

Background & Aim Osteoarthritis (OA) is a degenerative debilitating disease characterized by progressive erosion of the articular cartilage and is a major cause of disability and chronic pain. Articular cartilage, due to its structural features, has demonstrated a poor regenerative capacity after an injury. 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). Growth factors (plasma) derived from bone marrow aspirate concentrate (BMPC) seems to be potential for the treatment of the cartilage injured but there is no strong evidence of their use. Methods, Results & Conclusion Level I, prospective, descriptive study, between January 2018 and December 2019. 69 patients, range: 45-89 years, with knee OA Kellgren Lawrence (K-L) grade III and IV received one intra-articular injection of BMMNCs and BMPC in a same syringe (3ml) in a medium dose of 1.26 × 10 (9)/ml Mononuclear Cells and 704.000/ml Platelets. The main symptoms of knee osteoarthritis and tissue structure changes were evaluated after 12 months comparing the Visual Analogue Score (VAS) and Knee Injury and Orthopedic Outcome Score (KOOS) at different times. KOOS score was obtained at 3 months for 25 patients, 6 months for 12 patients and 12 months for 7 patients. The median KOOS score at the time “0 to 3 months” showed a statistically significant increase with respect to the initial moment (p <0.001) and a reduction to the moment “3 to 6 months” with respect to the previous moment that was not statistically significant (p = 0.313). Finally, the median of the KOOS returns to present a reduction at the last moment, “12 months”, with respect to “3 to 6 months” of similar magnitude to the previous reduction. The initial VAS value varied between 4 and 10 with the median being equal to 8.5 in the patients. In all cases, Global KOOS Score increase from the initial moment to the “0 to 3 months” was significant (p <0.001 for all subscales). No significant difference was found between the medians of the score at the “0 to 3 months” and “3 to 6 months” (symptoms: p = 1,000; stiffness: p = 0.423; pain: p = 0.313; functioning in daily activities: p = 0.313; functioning in sports and recreation activities: p = 0.125; quality of life: p = 1,000). The intraarticular implantation of a single dose of BMMNCs and BMPC for the treatment of Knee OA is a safe protocol and could improve quality of patient's life. In this study no adverse effects were seen. Osteoarthritis (OA) is a degenerative debilitating disease characterized by progressive erosion of the articular cartilage and is a major cause of disability and chronic pain. Articular cartilage, due to its structural features, has demonstrated a poor regenerative capacity after an injury. 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). Growth factors (plasma) derived from bone marrow aspirate concentrate (BMPC) seems to be potential for the treatment of the cartilage injured but there is no strong evidence of their use. Level I, prospective, descriptive study, between January 2018 and December 2019. 69 patients, range: 45-89 years, with knee OA Kellgren Lawrence (K-L) grade III and IV received one intra-articular injection of BMMNCs and BMPC in a same syringe (3ml) in a medium dose of 1.26 × 10 (9)/ml Mononuclear Cells and 704.000/ml Platelets. The main symptoms of knee osteoarthritis and tissue structure changes were evaluated after 12 months comparing the Visual Analogue Score (VAS) and Knee Injury and Orthopedic Outcome Score (KOOS) at different times.