Abstract
BackgroundKnee 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.MethodsPain 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).ResultsThe 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).ConclusionsIntra-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 abstractIntra-articular autologous BMAC therapy is safe and provides more relief to patients with symptomatic knee osteoarthritis compared to PRP therapy.
Highlights
Osteoarthritis (OA) is a degenerative joint disease impeding human body biomechanics and resulting in poor quality of life [1]
Intra-articular autologous bone marrow aspirate concentrate (BMAC) therapy is safe and provides more relief to patients with symptomatic knee osteoar‐ thritis compared to platelet-rich plasma (PRP) therapy
Baseline demographics and clinical characteristics As seen in other studies [20, 33], data analyzed per patient were from either unilaterally or bilaterally injected knees
Summary
Osteoarthritis (OA) is a degenerative joint disease impeding human body biomechanics and resulting in poor quality of life [1]. OA of the knee is very frequent and results from the progressive degeneration of articular cartilage either idiopathically or following structural changes or trauma [4]. Standard care for knee OA includes conservative therapies or surgery [6] Despite their affordability, management of pain, and/or delay of cartilage degeneration, conservative approaches like physiotherapy, analgesics, and intra-articular corticosteroid or hyaluronic acid (HA) injections have short-term efficacy and are still unproven to modify the disease [7]. 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
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