Abstract
Osteoarthritis [OA] of knee is a common cause of disability worldwide. The number of non-operative treatment options is on the rise. Orthobiologic therapy has emerged as a novel yet effective modality for early OA. It aims at achieving biologic repair, by repairing the damaged joint surface with autologous articular cartilage. Exploiting the healing and rejuvenating properties of body's own cells for the repair and renewal of damaged tissues is the basic crux behind orthobiologic therapy. Creation of an ambient structural, biological and biomechanical environment is an essential prerequisite for successful orthobiologic therapy. There are a number of orthobiologic options - platelet rich plasma (PRP), bone marrow concentrate (BMC), adipose tissue derived mesenchymal stem cells (ADMSC), autologous chondrocyte implantation (ACI) and autologous conditioned serum. This review article discusses the clinical indications, rationale, preparation, pros and cons of each one of them in detail along with a comprehensive review of published literature.
Highlights
Osteoarthritis (OA) of knee is one of the most common clinical scenarios presenting in an orthopaedic clinic
The innovative biological options which have been successful in the management of osteoarthritis include platelet rich plasma (PRP), bone marrow concentrate (BMC), adipose tissue derived mesenchymal stem cells (ADMSC), autologous chondrocyte implantation (ACI) and autologous conditioned serum
The following studies establish the supremacy of PRP over hyalyuronic acid (HA) for OA knee: In 2011, a randomized controlled trial (RCT) involving 150 patients with early OA by Kon et al [13] compared the clinical outcome after intra-articular PRP versus low and high molecular weight HA in three patient groups
Summary
Osteoarthritis (OA) of knee is one of the most common clinical scenarios presenting in an orthopaedic clinic. Orthobiologics have evolved as one of the prominent treatment modalities for early osteoarthritis (OA) of the knee. Unabated interests and incessant research in the field of regenerative medicine, coupled with promising clinical results from the use of orthobiologics are diversifying the clinical applications of this “cutting-edge” biological treatment day by day. Exploiting the healing and rejuvenating properties of body’s own cells for the repair and renewal of damaged tissues is the basic crux behind orthobiologic therapy. The innovative biological options which have been successful in the management of osteoarthritis include platelet rich plasma (PRP), bone marrow concentrate (BMC), adipose tissue derived mesenchymal stem cells (ADMSC), autologous chondrocyte implantation (ACI) and autologous conditioned serum. This review predominantly focuses on contemporary autologous biologic agents that are being used for the clinical treatment of OA knee. This review does not include in vitro or animal studies, those studies involving allogenic or synthetic agents and those studies focusing on isolated chondral pathologies rather than generalized OA
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