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Intraosseous Injection of Autologous Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for Treatment of Knee Osteoarthritis

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1. Title Title of document Intraosseous Injection of Autologous Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for Treatment of Knee Osteoarthritis
2. Creator Author's name, affiliation, country Dmitriy A. Malanin; Volgograd State Medical University; Russian Federation
2. Creator Author's name, affiliation, country Vladimir D. Sikilinda; Rostov State Medical University ; Russian Federation
2. Creator Author's name, affiliation, country Andrei I. Gorbatenko; Rostov State Medical University ; Russian Federation
2. Creator Author's name, affiliation, country Maxim V. Demeshchenko; Volgograd State Medical University ; Russian Federation
2. Creator Author's name, affiliation, country Il’ya A. Suchilin; Volgograd State Medical University; Russian Federation
2. Creator Author's name, affiliation, country Vladimir V. Kondrashenko; Volgograd State Medical University ; Russian Federation
2. Creator Author's name, affiliation, country Nataliya O. Kostyanaya; Southern Federal University; Russian Federation
3. Subject Discipline(s)
3. Subject Keyword(s) bone marrow aspirate concentrate; platelet-rich plasma; knee osteoarthritis
4. Description Abstract

The aim of the study was to determine the effectiveness of autologous bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) intraosseous injection in the treatment of patients with knee OA stages II-III.

Methods: The multicenter randomized study involved 40 patients (27 women, 13 men, average age 67.0±7.8 years, BMI 32.7±4.8, duration of disease 17.3±3.7 months) with knee OA of stages II-III according to the Kellgren-Lawrence (K-L) classification. Patients of the main (BMAC group) group (n=19) underwent a single intraosseous injection of BMAC, in the comparison group (n = 21) – a PRP injection (PRP group). The results were evaluated after 1, 3, 6, 12 months with the verbal rating scale (VRS), VAS, Leken and WOMAC scales.

Results: Comparison of the results in the groups on the VRS showed that at an earlier time (3 and 6 months), the preferences of patients were in favor of the treatment of BMAC (65% and 55% positive reviews) before PRP (55% and 45% positive reviews), whereas after 12 months the differences were insignificant. Analysis of VAS indicators in patients of both groups indicated a more pronounced decrease in the severity of pain syndrome after BMAC intraosseous injection. The analysis of the Leken scale indicators showed in favor of BMAC throughout the entire observation period, the differences were most pronounced in the first 3 months of observation. The ratio of the values of the WOMAC index in both patients groups indicated statistically significant differences that persisted in all periods of follow-up, the increase in indicators occurred to a lesser extent after the introduction of BMAC compared with PRP.

Conclusions: A single intraosseous BMAC injection has an advantage over a similar PRP injection in terms of pain, knee function and physical activity of patients at all follow-up periods. Both methods of treatment are equally safe.

5. Publisher Organizing agency, location Vreden National Medical Research Center of Traumatology and Orthopedics
6. Contributor Sponsor(s) State budget financing
7. Date (DD-MM-YYYY) 29.12.2021
8. Type Status & genre Peer-reviewed Article
8. Type Type Research Article
9. Format File format
10. Identifier Uniform Resource Identifier https://journal.rniito.org/jour/article/view/1669
10. Identifier Digital Object Identifier (DOI) 10.21823/2311-2905-1669
10. Identifier Digital Object Identifier (DOI) (PDF (Rus)) 10.21823/2311-2905-1669-1157
10. Identifier Digital Object Identifier (DOI) (PDF (Eng)) 10.17816/2311-2905-1669-1220
10. Identifier Digital Object Identifier (DOI) (PDF (简体中)) 10.17816/2311-2905-1669-1225
11. Source Title; vol., no. (year) Traumatology and Orthopedics of Russia; Vol 27, No 4 (2021)
12. Language English=en ru
13. Relation Supp. Files Fig. 1. MRI picture of the aseptic necrosis zone of the femoral condyle intero-posterior compartment in T1 mode: a — coronary section; b — sagittal section (21KB) doi: 10.21823/2311-2905-1669-3043
Fig. 2. Zone of overload edema of the femoral and tibial condyles in T1 mode: a — coronary section; b — sagittal section (24KB) doi: 10.21823/2311-2905-1669-3044
Fig. 3. PRP preparation: a — level of the hematocrit layer after the first centrifugation; b — platelet layer sampling (17KB) doi: 10.21823/2311-2905-1669-3045
Fig. 4. Injection of BMAC under fluoroscopic control into the area of overload edema of the bone marrow of the internal femoral condyle (7KB) doi: 10.21823/2311-2905-1669-3046
Fig. 5. Decrease in signal intensity and the size of the bone marrow edema zone in the area of the femoral and tibial condyles after injection of BMAC: a — before injection; b — after 3 months (22KB) doi: 10.21823/2311-2905-1669-3047
14. Coverage Geo-spatial location, chronological period, research sample (gender, age, etc.)
15. Rights Copyright and permissions Copyright (c) 2021 Malanin D.A., Sikilinda V.D., Gorbatenko A.I., Demeshchenko M.V., Suchilin I.A., Kondrashenko V.V., Kostyanaya N. .
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