Clinical and functional evaluation of bone marrow aspirate concentrate vs autologous conditioned serum in the treatment of knee osteoarthritis

Main Article Content

Matteo Vitali
Marco Ometti
Pierluigi Pironti
Damiano Salvato
Alice Sandrucci
Orlando Leone
Vincenzo Salini

Keywords

Knee osteoarthritis; biological therapies; Bone Marrow Aspirate Concentrate; Autologous Conditioned Serum.

Abstract

Background and aim: The aim of this study was to compare the efficacy of a single Bone Marrow Aspirate Concentrate (BMAC) with a cycle of 4 Autologous Conditioned Serum (ACS) injections in the treatment of early-stage knee osteoarthritis (OA).


Methods: Two groups of 12 patients with degenerative knee OA were treated with a single BMAC injection and with a cycle of 4 ACS injections respectively. Follow-up was set at baseline (t0), one-month (t1) and six-months (t2) evaluating VAS for pain, WOMAC index and range of motion (ROM).


Results: We reported a significant improvement in WOMAC after BMAC injection both at t1 (p= 0,001) as well as t2 (p< 0,001), plus a reduction of VAS values in BMAC group at six months follow-up (p = 0,024). In contrast, no significant differences in ROM between the two groups were observed.


Conclusions: Both the approaches are safe and effective in the treatment of knee OA, with a major efficacy of BMAC.

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References

1. Harrell CR, Markovic BS, Fellabaum C, Arsenijevic A, Volarevic V. Mesenchymal stem cell-based therapy of osteoarthritis: Current knowledge and future perspectives. Biomedicine and Pharmacotherapy 2019;109(November 2018):2318-2326.
2. Emadedin M, Liastani MG, Fazeli R, et al. Long-term follow-up of intra-articular injection of autologous mesenchymal stem cells in patients with knee, ankle, or hip osteoarthritis. Archives of Iranian Medicine 2015;18(6):336-344.
3. Mautner K, Bowers R, Easley K, Fausel Z, Robinson R. Functional Outcomes Following Microfragmented Adipose Tissue Versus Bone Marrow Aspirate Concentrate Injections for Symptomatic Knee Osteoarthritis. STEM CELLS Translational Medicine 2019:1-8.
4. Themistocleous GS, Chloros GD, Kyrantzoulis IM, et al. Effectiveness of a single intra-articular bone marrow aspirate concentrate (BMAC) injection in patients with grade 3 and 4 knee osteoarthritis. Heliyon 2018;4(10):e00871.
5. Kong L, Zheng LZ, Qin L, Ho KKW. Role of mesenchymal stem cells in osteoarthritis treatment. Journal of Orthopaedic Translation 2017;9:89-103.
6. Pers YM, Ruiz M, Noël D, Jorgensen C. Mesenchymal stem cells for the management of inflammation in osteoarthritis: State of the art and perspectives. Osteoarthritis and Cartilage 2015;23(11):2027-2035.
7. Wang W jun, Sun M hui, Palmer J, et al. Patterns of Compartment Involvement in End-stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice. Orthopaedic Surgery 2018;10(3):227-234.
8. Strümper R. Intra-Articular Injections of Autologous Conditioned Serum to Treat Pain from Meniscal Lesions. Sports Med Int Open 2017:200-205.
9. Blázquez R, Sánchez-Margallo FM, Reinecke J, et al. Conditioned Serum Enhances the Chondrogenic and Immunomodulatory Behavior of Mesenchymal Stem Cells. Frontiers in Pharmacology 2019;10:1-11.
10. Park HJ, Kim SS, Lee SY, et al. A practical MRI grading system for osteoarthritis of the knee: association with Kellgren-Lawrence radiographic scores. European journal of radiology 2013;82(1):112-117.
11. Hayes B, Kittelson A, Loyd B, Wellsandt E, Flug J, Stevens-Lapsley J. Assessing Radiographic Knee Osteoarthritis: An Online Training Tutorial for the Kellgren-Lawrence Grading Scale. MedEdPORTAL Publications. 2016; 12:10503.
12. Chahla J, Mannava S, Cinque ME, Geeslin AG, Codina D, LaPrade RF. Bone Marrow Aspirate Concentrate Harvesting and Processing Technique. Arthroscopy Techniques 2017;6(2):e441-e445.
13. Meijer H, Reinecke J, Becker C, Tholen G, Wehling P. The production of anti-inflammatory cytokines in whole blood by physico-chemical induction. Inflammation Research 2003;52(10):404-407.
14. Vitali M, Ometti M, Drossinos A, Pironti P, Santoleri L, Salini V. Autologous conditioned serum: clinical and functional results using a novel disease modifying agent for the management of knee osteoarthritis. Journal of Drug Assessment 2020;9(1):43-51.
15. Subaşı V, Ekiz T. Bone marrow aspiration concentrate and platelet-rich plasma in the treatment of knee osteoarthritis: A report of three cases. Complement Ther Clin Pract 2019;34:113-115.
16. Chahal J, Gómez-Aristizábal A, Shestopaloff K, et al. Bone Marrow Mesenchymal Stromal Cells in Patients with Osteoarthritis Results in Overall Improvement in Pain and Symptoms and Reduces Synovial Inflammation. Stem Cells Translational Medicine Stem Cells Transl Med 2019;8(8):746-757.
17. Shapiro SA, Arthurs JR, Heckman MG, et al. Quantitative T2 MRI Mapping and 12-Month Follow-up in a Randomized, Blinded, Placebo Controlled Trial of Bone Marrow Aspiration and Concentration for Osteoarthritis of the Knees. Cartilage 2018.
18. Kim J Do, Lee GW, Jung GH, et al. Clinical outcome of autologous bone marrow aspirates concentrate (BMAC) injection in degenerative arthritis of the knee. Eur J Orthop Surg Traumatol 2014;24(8):1505-1511.
19. Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: Systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2017;12(1):1-12.
20. Bennell KL, Hunter DJ, Paterson KL. Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis. Curr Rheumatol Rep 2017;19(5):24.
21. Evans CH, Chevalier X, Wehling P. Autologous Conditioned Serum. Phys Med Rehabil Clin N Am 2016;27(4):893-908.
22. Yang KGA, Raijmakers NJH, van Arkel ERA, et al. Autologous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial. Osteoarthritis and Cartilage. 2008;16(4):498-505.
23. Barreto A, Braun TR. A new treatment for knee osteoarthritis: Clinical evidence for the efficacy of ArthrokinexTM autologous conditioned serum. J Orthop 2017;14(1):4-9.
24. Zarringam D, Bekkers JEJ, Saris DBF. Long-term Effect of Injection Treatment for Osteoarthritis in the Knee by Orthokin Autologous Conditioned Serum. Cartilage. 2018;9(2):140-145.