Comparative evaluation of the effectiveness of autological bone marrow aspirate concentrate and platelete-rich plasma injected intraosseously in the treatment of the knee osteoarthritis

Abstract

The aim of the study was a comparative evaluation of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), administered intraosseously to patients with stage IIIII knee osteoarthritis (OA) according to the Kellgren Lawrence (K-L) classification. Materials and methods: 40 patients were recruited and divided into 2 groups for the multicenter randomized study. Patients in the main group (n = 19) underwent a single intraosseous BMAC injection, and those in the comparison group (n = 21) had a similar procedure, but with the use of PRP. Treatment results were assessed at follow-up after 1, 3, 6, and 12 months using the verbal patient satisfaction scale (VSS), visual analog scale (VAS), WOMAC index (Western Ontario and MCMaster Universities osteoarthritis index), and Leken. Results: Estimated effectiveness of the application according to VSS from 1 to 6 months of observation, the opinions of patients were intercepted in the direction of BMAC (up to 65% of positive reviews) in the detection of PRP (up to 55 % of positive reviews). However, during the period of 6 to 12 months of observation we did not get significant results. Interpretation of the application of the VAS scale indicated a pronounced decrease of pain in both groups of patients. However, in the PRP group pain scores were higher. Analysis of the treatment results according to the WOMAC scale allows us to identify significant differences at all periods of observation with the prevalence of results in the BMAC group. Evaluation of the efficacy of therapy according to the Leken index indicated a more than twofold decrease in the index in the first month of observation. Subsequently, we noticed insignificant negative dynamic up to the 12th month of observation. When checking data between groups, the statistical data was significantly better in BMAC group. Conclusion. A single intraosseous injection of BMAC has an advantage at all control periods of observation in comparison with a similar injection of PRP. Both treatments do not cause serious complications.