Abstract
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.
Highlights
Osteoarthritis (OA) is a multifactorial joint disease that can lead to pain, dysfunction and a decreased quality of life [1]
The aim of this study was to evaluate the clinical effectiveness of three intra-articular injections (HA, autologous conditioned serum (ACS) and bone marrow aspirate concentrate (BMAC)) in the treatment of symptomatic knee OA
Some patients were lost to follow-up which resulted in 145 hyaluronic acid (HA) cases (84%), 201 ACS cases (90.5%) and 98 BMAC cases (87.5%) at 3 months; and 30 HA cases (17.5%), 50 ACS cases (22.5%) and 25 BMAC cases (22.3%) at 12 months (Figure 1)
Summary
Osteoarthritis (OA) is a multifactorial joint disease that can lead to pain, dysfunction and a decreased quality of life [1]. Over the past two decades, the use of naturally derived preparations, called orthobiologics, for various orthopedic conditions has become increasingly popular, including for the management of knee OA. This includes the improvement or regeneration of different musculoskeletal tissues by means of biomaterials (e.g., hyaluronic acid (HA)), stem cells and growth factors (e.g., platelet-rich plasma (PRP)) [6,7]
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