Intra-Articular Bone Marrow Aspirate Concentrate Injection in Patients with Knee Osteoarthritis

Gi Beom Kim,Chang Hyun Choi,Young Choi,Gun Woo Lee,Jae-Do Kim

doi:10.3390/app10175945

Abstract

We aimed to evaluate the 5-year follow-up outcomes of an intra-articular bone marrow aspirate concentrate (BMAC) injection in patients with knee osteoarthritis. This is the first study to report the outcomes following BMAC injections over a 5-year follow-up period. Seventy knees of 37 patients, including 33 bilateral knees, were investigated. The primary outcome was the visual analogue scale (VAS) score for pain in the knee joint, and the secondary outcomes were the International Knee Documentation Committee score, the 36-Item Short Form Health Survey score, the Knee injury Osteoarthritis Outcome Score, Lysholm Knee Questionnaire/Tegner activity scale, BMAC injection-induced complications, and 5-year treatment success rate. The 5-year post-injection VAS scores (4.7 ± 0.5) were significantly lower than the preoperative scores (8.3 ± 1.2) (p = 0.01). Improvement in VAS scores was significantly greater in patients with Kellgren–Lawrence (K-L) Grade I or II than those in those with K-L Grade III or IV. Improvement in other clinical parameters and success rates were significantly low and the rates of secondary operation and failure were significantly higher in patients with K-L Grades III or IV. Intra-articular BMAC injections could be useful for managing patients with K-L Grades I or II osteoarthritis.

Highlights

Extensive studies have been performed on regenerative therapies for osteoarthritis (OA) and cartilage defects in the knee joint [1,2,3,4,5]
A strong body of evidence shows that the human bone marrow (BM) is a source of mesenchymal stem cells (MSCs) and growth factors that aid cartilage regeneration [6,7,8,9]
A bone marrow aspirate concentrate (BMAC) injection is one such method of intra-articular delivery of growth factors, which is currently approved by the United States Food and Drug Administration (FDA) [12]

Summary

Introduction

Extensive studies have been performed on regenerative therapies for osteoarthritis (OA) and cartilage defects in the knee joint [1,2,3,4,5]. A strong body of evidence shows that the human bone marrow (BM) is a source of mesenchymal stem cells (MSCs) and growth factors that aid cartilage regeneration [6,7,8,9]. The BM plays an important role in cartilage regeneration. Alternatives, such autologous BM cells, have been used in recent times to achieve maximal regeneration with minimal ethical and/or other issues [1,3,10,11]. A bone marrow aspirate concentrate (BMAC) injection is one such method of intra-articular delivery of growth factors, which is currently approved by the United States Food and Drug Administration (FDA) [12]. A few clinical studies have demonstrated that intra-articular BMAC injections in patients with knee OA might produce favorable results in terms of clinical parameters and

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Discussion

Conclusion