The comparison of knee osteoarthritis treatment with single-dose bone marrow-derived mononuclear cells vs. hyaluronic acid injections
| Autor: | Kristaps Erglis, Eriks Jakobsons, Liene Patetko, Andrejs Erglis, Ieva Briede, Martins Erglis, Valdis Goncars, Kristaps Blums, Indrikis Muiznieks, Konstantins Kalnberzs |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Sodium hyaluronate Knee osteoarthritis Bone marrow mononuclear cells Cartilage Urology Osteoarthritis Knee Joint Peripheral blood mononuclear cell Monocytes Injections Intra-Articular 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Statistical significance Hyaluronic acid Humans Medicine Hyaluronic Acid Adverse effect Aged Bone Marrow Transplantation Medicine(all) 030203 arthritis & rheumatology 030222 orthopedics lcsh:R5-920 business.industry Middle Aged Osteoarthritis Knee medicine.disease Treatment Outcome medicine.anatomical_structure chemistry Automotive Engineering Female Bone marrow business lcsh:Medicine (General) |
| Zdroj: | Medicina, Vol 53, Iss 2, Pp 101-108 (2017) Medicina Volume 53 Issue 2 Pages 101-108 Medicina; Volume 53; Issue 2; Pages: 101-108 |
| Popis: | Objective: The aim of this study was to compare treatment methods of the knee joint degenerative osteoarthritis, using autologous bone marrow-derived mononuclear cells and hyaluronic acid injections and observe prevalence of adverse effects in both groups. Materials and methods: A prospective randomized controlled clinical trial was carried out. The analysis of pain and changes in osteoarthritis symptoms after a single intra-articular bone marrow-derived mononuclear cell injection into the knee joint in the Kellgren– Lawrence stage II–III osteoarthritis during the 12-month period were performed. The results were compared with the control group treated routinely by hyaluronic acid injections therapy. A therapy group of patients (n = 28) received single bone marrow-derived mononuclear cell intra-articular injections. A control group of patients (n = 28) was treated with a total of three sodium hyaluronate intra-articular injections each one performed a week apart. The clinical results were obtained using the Knee Osteoarthritis Outcome Score (KOOS) and the Knee Society Score (KSS) before and 3, 6, and 12 months after injection.Results: A statistically significant improvement was observed in the mononuclear cell group over the starting point in all scores. At the endpoint at month 12, the KOOS score improved significantly (P < 0.05) on the pain subscale (+25.44), activity and daily living subscale (+21.36), quality of life subscale (+28.83), and total KOOS (+18.25). The KSS score also demonstrated a significant improvement on the symptoms subscale (+25.42) and the function subscale (+38.32) (P < 0.001). The KOOS symptoms and sports subscales improved without statistical significance. The difference between the control group treated with hyaluronic acid versus the bone marrow-derived mononuclear cells group at time points 6 and 12 months demonstrated a statistically significant (P < 0.05) superiority in the KOOS pain subscale over the hyaluronic acid group. In both groups serious adverse effects were not observed.Conclusions: The intra-articular injection of bone marrow-derived mononuclear cells is a safe manipulation with no side effects during the 12-month period. This treatment provides statistically significant clinical improvement between the starting point and 1, 3, 6, and 12 months after. When compared to hyaluronic acid treatment, better pain relief in the longterm period of mononuclear cell group was observed. |
| Databáze: | OpenAIRE |
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