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Regenerative Medicine

The role of osteoarthritis severity, BMI and age on clinical efficacy of bone marrow aspirate concentrate in the treatment of knee osteoarthritis

    Predrag Rasovic

    University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia

    ,
    Oliver Dulic

    *Author for correspondence:

    E-mail Address: oliver.dulic@mf.uns.ac.rs

    University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia

    ,
    Ivica Lalic

    University Business Academy in Novi Sad, Faculty Of Pharmacy, Novi Sad, Serbia

    ,
    Radmila Matijevic

    University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia

    ,
    Natasa Janjic

    University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia

    ,
    Milan Tosic

    University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia

    ,
    Dejan Aleksandric

    Institute for Orthopaedic Surgical Diseases “Banjica”, Belgrade, Serbia

    , , , &
    Published Online:https://doi.org/10.2217/rme-2023-0042

    Aim: The aim of this study was to assess whether BMI, severity of knee osteoarthritis, age and gender have any influence on the final clinical results of bone marrow aspirate concentrate injection. Method: A total of 111 study participants with painful knee osteoarthritis and different characteristics concerning before mentioned factors underwent bone marrow aspirate concentrate (BMAC) therapy and were followed up for 1 year. Result: Significant pain and functional improvement were observed in all participant groups. Participants' age and BMI did not influence the clinical outcome, but there was an influence of OA severity, especially among older patients. Conclusion: This study shows that BMAC therapy is effective. Younger patients with milder OA changes could be better candidates for long-lasting and more efficient BMAC therapy.

    Clinical Trial Registration:NCT03825133 (ClinicalTrials.gov)

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthr. Cartil. 21(1), 16–21 (2013).
    • 2. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheumatol. 64(6), 1697–1707 (2012).
    • 3. Cross M, Smith E, Hoy D et al. The global burden of hip and knee osteoarthritis: Estimates from the Global Burden of Disease 2010 study. Ann. Rheum. Dis. 73(7), 1323–1330 (2014).
    • 4. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet 393(10182), 1745–1759 (2019).
    • 5. Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract. Res. Clin. Rheumatol. 28(1), 5–15 (2014).
    • 6. Dell'Isola A, Allan R, Smith SL, Marreiros SSP, Steultjens M. Identification of clinical phenotypes in knee osteoarthritis: a systematic review of the literature. BMC Musculoskelet. Disord. 17(1), 425 (2016). •• In this study, the authors shed light on a completely new perspective of osteoarthritis (OA), opening up new horizons for clinical research in this field.
    • 7. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis Ann Rheum Dis 1957. Ann. Rheum. Dis. 16(4), 494–503 (1956).
    • 8. Mahmoudian A, Lohmander LS, Mobasheri A, Englund M, Luyten FP. Early-stage symptomatic osteoarthritis of the knee—time for action. Nat. Rev. Rheumatol. 17(10), 621–632 (2021).
    • 9. Madry H, Kon E, Condello V et al. Early osteoarthritis of the knee. Knee Surgery, Sport. Traumatol. Arthrosc. 24, 1753–1762 (2016).
    • 10. Hussain SM, Neilly DW, Baliga S, Patil S, Meek RMD. Knee osteoarthritis: a review of management options. Scott. Med. J. 61(1), 7–16 (2016).
    • 11. Sconza C, Leonardi G, Carfì C et al. Intra-Articular Injection of Botulinum Toxin for the Treatment of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials. Int. J. Mol. Sci. 24(2), 1486 (2023).
    • 12. Kan HS, Chan PK, Chiu KY et al. Non-surgical treatment of knee osteoarthritis. Hong Kong Med. J. 25(2), 127–133 (2019).
    • 13. Stefik D, Vranic V, Ivkovic N et al. An insight into osteoarthritis susceptibility: integration of immunological and genetic background. Bosn. J. Basic Med. Sci. 21(2), 155–162 (2021).
    • 14. Dulić O, Lalić I, Janjić N, Rašović P, Gavrilović G, Abazović D. In step with contemporary trends-stem-celltherapy as a key driver of regenerative orthopedics at the Clinical Center of Vojvodina-preliminary data for the treatment of knee osteoarthritis and osteochondral lesions. Med. Pregl. 69(Suppl. 1), 77–84 (2016).
    • 15. Weber AE, Bolia IK, Trasolini NA. Biological strategies for osteoarthritis: from early diagnosis to treatment. Int. Orthop. 45(2), 335–344 (2021).
    • 16. Han Y, Li X, Zhang Y, Han Y, Chang F, Ding J. Mesenchymal stem cells for regenerative medicine. Cells 8(8), 886 (2019).
    • 17. Kim GB, Seo MS, Park WT, Lee GW. Bone marrow aspirate concentrate: its uses in osteoarthritis. MDPI AG 21(9), 3224 (2020).
    • 18. Cavallo C, Boffa A, de Girolamo L et al. Bone marrow aspirate concentrate quality is affected by age and harvest site. Knee Surgery, Sport. Traumatol. Arthrosc. 31(6), 2140–2151 (2022).
    • 19. Zha K, Li X, Yang Z et al. Heterogeneity of mesenchymal stem cells in cartilage regeneration: from characterization to application. Nature Research. 19(6), 1–14 (2021).
    • 20. Dulic O, Rasovic P, Lalic I et al. Bone marrow aspirate concentrate versus platelet rich plasma or hyaluronic acid for the treatment of knee osteoarthritis. Medicina (B. Aires). 57(11), 1193 (2021).
    • 21. Keeling LE, Belk JW, Kraeutler MJ et al. Bone Marrow Aspirate Concentrate for the Treatment of Knee Osteoarthritis: A Systematic Review. SAGE Publications Inc 50(8), 2315–2323 (2022).
    • 22. Wagner BS, Howe AS, Dexter WW et al. Tolerability and Efficacy of 3 Approaches to Intra-articular Corticosteroid Injections of the Knee for Osteoarthritis: A Randomized Controlled Trial. Orthop. J. Sport. Med. 3(8), 2325967115600687 (2015).
    • 23. Dulic O, Lalic I, Kecojevic V et al. Do knee injection portals affect clinical results of bone marrow aspirate concentrate injection in the treatment of osteoarthritis? A prospective randomized controlled study. Regen. Med. 15(8), 1987–2000 (2020). • This study is crucial for the purpose of this manuscript as it explores the role of knee portals in the clinical efficacy of bone marrow aspirate concentrate (BMAC) injections.
    • 24. Centeno C, Pitts J, Al-Sayegh H, Freeman M. Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. Biomed Res. Int. 2014, 370621 (2014). •• This paper represents one of the pioneering research studies that establishes a foundation for clinical investigations involving bone marrow aspirate concentrate (BMAC).
    • 25. Gursoy S, Akkaya M, Simsek ME, Bozkurt M. Functional outcomes of bone marrow aspirate concentrate application in osteoarthritis of the knee. Int. J. Res. Med. Sci. 7(2), 587 (2019).
    • 26. Kim GB, Kim J-D, Choi Y, Choi CH, Lee GW. Intra-articular bone marrow aspirate concentrate injection in patients with knee osteoarthritis. Appl. Sci. 10(17), 5945 (2020).
    • 27. Tur–Kaspa I. Clinical outcome of PGD. Reprod. Biomed. Online. 16, S13 (2008).
    • 28. Reyes C, Leyland KM, Peat G, Cooper C, Arden NK, Prieto-Alhambra D. Association between overweight and obesity and risk of clinically diagnosed knee, hip, and hand osteoarthritis: a population-based cohort study. Arthritis Rheumatol. 68(8), 1869–1875 (2016).
    • 29. Conrozier T, Eymard F, Chouk M, Chevalier X. Impact of obesity, structural severity and their combination on the efficacy of viscosupplementation in patients with knee osteoarthritis. BMC Musculoskelet. Disord. 20(1), 376 (2019).
    • 30. Gobbi A, Karnatzikos G, Mahajan V, Malchira S. Platelet-Rich Plasma Treatment in Symptomatic Patients With Knee Osteoarthritis: Preliminary Results in a Group of Active Patients. Sport. Heal. A Multidiscip. Approach. 4, 162–172 (2012).
    • 31. Migliorini F, Rath B, Colarossi G et al. Improved outcomes after mesenchymal stem cells injections for knee osteoarthritis: results at 12-months follow-up: a systematic review of the literature. Arch. Orthop. Trauma Surg. 140, 853–868 (2019).
    • 32. Migliorini F, Driessen A, Quack V et al. Comparison between intra-articular infiltrations of placebo, steroids, hyaluronic and PRP for knee osteoarthritis: a Bayesian network meta-analysis. Arch. Orthop. Trauma Surg. 141, 1473–1490 (2021).
    • 33. Freitag J, Wickham J, Shah K, Tenen A. Real-world evidence of mesenchymal stem cell therapy in knee osteoarthritis: a large prospective two-year case series. Regen. Med. 17(6), 355–373 (2022). •• This trial is one of the largest research studies on adipose-derived mesenchymal stem cell therapy. It serves as a complementary investigation that, when combined with the real-world evidence case series, provides conclusive evidence of the efficacy of adipose-derived mesenchymal stem cell therapy in treating knee osteoarthritis. In the context of this manuscript, we have found further confirmation of our findings.
    • 34. Kim J-D, Lee GW, Jung GH et al. Clinical outcome of autologous bone marrow aspirates concentrate (BMAC) injection in degenerative arthritis of the knee. Eur. J. Orthop. Surg. Traumatol. 24(8), 1505–1511 (2014).