TY - JOUR
T1 - A specific protocol of autologous bone marrow concentrate and platelet products versus exercise therapy for symptomatic knee osteoarthritis
T2 - a randomized controlled trial with 2year follow-up
AU - Centeno, Christopher
AU - Sheinkop, Mitchell
AU - Dodson, Ehren
AU - Stemper, Ian
AU - Williams, Christopher
AU - Hyzy, Matthew
AU - Ichim, Thomas
AU - Freeman, Michael
PY - 2018/12/13
Y1 - 2018/12/13
N2 - BackgroundCell-based therapies have shown promise for the treatment of knee osteoarthritis (OA). The current study compared exercise therapy to autologous bone marrow concentrate (BMC) and platelet products for knee OA treatment.MethodsPatients with symptomatic knee OA (N=48) were randomized into either an exercise therapy control group or treatment group with injection of autologous BMC and platelet products. Patients in the control group could crossover to BMC treatment after 3months. Clinical outcomes were documented at baseline and at 6-weeks, 3, 6, 12 and 24months, including the Knee Society Score (KSS), Pain Visual Analogue Scale, Short Form-12 Scales (SF-12), and Lower Extremity Activity Scale (LEAS).ResultsAll patients in the exercise group crossed over to receive BMC treatment after 3months (N=22 crossover). At 3months, KSS-knee, SF-12 Physical, and LEAS improved significantly in the crossover group compared to exercise, similar to significant improvements on KSS-knee and LEAS for the treatment group (N=26) compared to exercise group at 3months. After BMC treatment, patients' clinical outcome scores (except SF-12 Mental Health), were significantly improved through the 2-year follow-up compared to baseline. No serious adverse events were reported.ConclusionThe use of image-guided percutaneous BMC with platelet products yielded better results than exercise therapy as an effective alternative therapy for patients with symptomatic moderate to moderate-severe osteoarthritis of the knee.Trial registration NCT02034032. https://clinicaltrials.gov/ct2/show/NCT02034032. Registered 13 January 2014
AB - BackgroundCell-based therapies have shown promise for the treatment of knee osteoarthritis (OA). The current study compared exercise therapy to autologous bone marrow concentrate (BMC) and platelet products for knee OA treatment.MethodsPatients with symptomatic knee OA (N=48) were randomized into either an exercise therapy control group or treatment group with injection of autologous BMC and platelet products. Patients in the control group could crossover to BMC treatment after 3months. Clinical outcomes were documented at baseline and at 6-weeks, 3, 6, 12 and 24months, including the Knee Society Score (KSS), Pain Visual Analogue Scale, Short Form-12 Scales (SF-12), and Lower Extremity Activity Scale (LEAS).ResultsAll patients in the exercise group crossed over to receive BMC treatment after 3months (N=22 crossover). At 3months, KSS-knee, SF-12 Physical, and LEAS improved significantly in the crossover group compared to exercise, similar to significant improvements on KSS-knee and LEAS for the treatment group (N=26) compared to exercise group at 3months. After BMC treatment, patients' clinical outcome scores (except SF-12 Mental Health), were significantly improved through the 2-year follow-up compared to baseline. No serious adverse events were reported.ConclusionThe use of image-guided percutaneous BMC with platelet products yielded better results than exercise therapy as an effective alternative therapy for patients with symptomatic moderate to moderate-severe osteoarthritis of the knee.Trial registration NCT02034032. https://clinicaltrials.gov/ct2/show/NCT02034032. Registered 13 January 2014
KW - Knee osteoarthritis
KW - Bone marrow concentrate
KW - Articular cartilage
KW - Regenerative therapy
KW - Exercise therapy
KW - MESENCHYMAL STEM-CELLS
KW - RICH PLASMA
KW - CARTILAGE
KW - ARTHRITIS
U2 - 10.1186/s12967-018-1736-8
DO - 10.1186/s12967-018-1736-8
M3 - Article
C2 - 30545387
SN - 1479-5876
VL - 16
JO - Journal of Translational Medicine
JF - Journal of Translational Medicine
M1 - 355
ER -