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.

Autor:	Shapiro SA; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA., Arthurs JR; Division of Transplant Medicine, Mayo Clinic, Jacksonville, FL, USA., Heckman MG; Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA., Bestic JM; Department of Radiology, Mayo Clinic, Jacksonville, FL, USA., Kazmerchak SE; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA., Diehl NN; Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA., Zubair AC; Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA., O'Connor MI; Department of Orthopedic Surgery, Yale-New Haven Hospital, New Haven, CT, USA.
Jazyk:	angličtina
Zdroj:	Cartilage [Cartilage] 2019 Oct; Vol. 10 (4), pp. 432-443. Date of Electronic Publication: 2018 Aug 30.
DOI:	10.1177/1947603518796142
Abstrakt:	Objective: Bone marrow aspiration and concentration (BMAC) is becoming a more common regenerative therapy for musculoskeletal pathology. In our current pilot study, we studied patients with mild-to-moderate bilateral knee osteoarthritis, compared pain at 12-month follow-up between BMAC-injected and saline-injected knees, and examined cartilage appearance measured by magnetic resonance imaging (MRI) T2 quantitative mapping. Design: Twenty-five patients with mild-to-moderate bilateral osteoarthritic knee pain were randomized to receive BMAC into one knee and saline placebo into the other. Bone marrow was aspirated from the iliac crests, concentrated in an automated centrifuge, combined with platelet-poor plasma for knee injection, and compared with saline injection into the contralateral knee. Primary outcome measures were T2 MRI cartilage mapping at 6-month and Visual Analog Scale and Osteoarthritis Research Society International Intermittent and Constant Osteoarthritis Pain scores and radiographs at 12-month follow-up. Results: Constant, intermittent, and overall knee pain remained significantly decreased from baseline at 12-month follow-up (all P ⩽ 0.01), with no apparent difference between BMAC- and saline-treated knees (all P ⩾ 0.54). A similar significant increase from baseline to 12-month follow-up regarding quality of life was observed for both BMAC- and saline-treated knees (all P ⩽ 0.04). T2 quantitative MRI mapping showed no significant changes as a result of treatment. Conclusions: BMAC is safe to perform and relieves pain from knee arthritis but showed no superiority to saline injection at 12-month follow-up. MRI cartilage sequences failed to show regenerative benefit with single BMAC injection. The mechanisms of action that led to pain relief remain unclear and warrant further studies.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu