Clinical Outcome of Bone Marrow Concentrate in Knee Osteoarthritis
Abstract
Background:
Knee osteoarthritis is an increasing health concern in the adult population. Nonsurgical treatment options for pain reduction and function improvement are limited in number and provide only short-term relief. The potential of regenerative therapies to go beyond temporary symptom reduction and delay or negate the need for total knee joint arthroplasty is enticing to both patients and
providers.
Purpose:
This study evaluated the clinical efficacy of autologous intra-articular bone marrow concentrate with autologous lipoaspirate as a treatment option for osteoarthritis of the knee. Additionally, bone marrow concentrate samples from a patient population subset not necessarily enrolled in this study, but IRB approved, were sent for outside laboratory analysis.
Study design:
This study is a prospective case series.
Methods:
Treatment registry data for 70 patients diagnosed with Kellgren-Lawrence Stage 2–4 knee osteoarthritis were analyzed. Data regarding adverse events and Knee injury and Osteoarthritis Outcome Score metrics were obtained at baseline, 90 days, and 180
days. Samples of bone marrow concentrate from 11 patients were sent to an outside source for laboratory analysis.
Results:
Adverse events were limited to transient pain and swelling of the treated joint. The mean reported KOOS changes from preprocedure to 180 days post-procedure were as follows: Pain + 18.1, Activities of Daily Living +15.6, Symptoms +17.3, Quality of Life +20.3,
and Sports/Recreation +18.1. Laboratory analysis of the samples demonstrated statistically significant increases in concentration of
platelets, interleukin-1 receptor antagonist and IL-1β. The IL-1ra/IL-1β ratio was also statistically significant at 193.54 when processed with a 2% Hct setting, and 720.62 when processed with a 15% Hct.
Conclusions:
This study of intra-articular injection of autologous bone marrow concentrate and lipoaspirate in patients diagnosed with knee osteoarthritis demonstrates encouraging results for positive outcomes without complication. Further study with randomized controlled trials is warranted to prove the potential of this intervention. With laboratory analysis of samples of bone marrow concentrate we
were able to identify the presence of statistically significant increases in the concentration of platelets and IL-ra.