Using orthobiologics products in knee osteoarthritis

Abstract

Objective: comparison of the treatment effectiveness in patients with grades II or III knee osteoarthritis using autologous bone marrow aspirate concentrate (BMAC) and autologous platelet-rich plasma (PRP) infused intraosseously into the area of overload bone marrow edema. Materials and Methods. The prospective study was conducted on the basis of two medical clinics from 2016 to 2019. It involved 40 patients with grades II–III knee osteoarthritis. The patients of the treatment group underwent a single intraosseous infusion of BMAC, whereas patients in the comparison group were subjected to a single intraosseous PRP infusion. The results were assessed after 1, 3, 6, and 12 months using visual analog scale (VAS), Lequesne index for knee osteoarthritis, WOMAC osteoarthritis index, and verbal rating scale (VRS). Results. After 12 months, there was a reduction in the VAS index to 3.9±0.3 points in the treatment group and 4.2±0.1 points in the control group. Similar decrease was observed for Lequesne index for knee osteoarthritis (to 5.8±0.7 points in the treatment group and to 6.1±0.8 points in the control group) and WOMAC osteoarthritis index (to 40.6±0.3 points in the treatment group and to 42.5±0.6 points in the control group). The VRS scores after 3 and 6 months were better in the treatment group (subjected to autologous BMAC), while after 12 months, the differences between the groups were not significant. Conclusion. Use of orthobiologics products for osteoarthritis treatment was effective, with higher efficacy of intraosseous BMAC infusion vs. PRP infusion in terms of pain, knee functionality, physical activity, and patient satisfaction over the entire monitoring period. Both treatment methods were safe.