Aim: Osteoarthritis (OA) is a highly prevalent and costly condition, rooted in cartilaginous defects. Despite various causes, the inability for chondrocytes to regenerate prohibits these lesions from self-healing. Debridement commonly provides symptomatic relief but does not target the underlying disease process, necessitating investigation into possible treatments. Intraosseous and intraarticular bone marrow aspirate concentrate (BMAC) injection is a new promising therapy aimed at repairing these cartilage defects. Methods/materials: We retrospectively reviewed patients who underwent BMAC chondroplasty and examined the efficacy in delaying need for further intervention. Results: Only 5 of 23 procedures (21.7%) required postoperative intervention within the 2-year follow-up period. Only one request for total knee arthroplasty was made, but the procedure has not been done. Conclusion: This study demonstrates that BMAC chondroplasty may be an efficacious method to delay need for total knee arthroplasty.

Keywords:

References

1. Koshino T, Machida J. Grading system of articular cartilage degeneration in osteoarthritis of the knee. Bull. Hosp. Jt Dis. 53(3), 41–46 (1993).
Medline CASGoogle Scholar
2. Smith B, Sigal IR, Grande DA. Immunology and cartilage regeneration. Immunol. Res. 63(1-3), 181–186 (2015).
Medline CASGoogle Scholar
3. Davies-Tuck ML, Wluka AE, Wang Y et al. The natural history of cartilage defects in people with knee osteoarthritis. Osteoarthritis Cartilage 16(3), 337–342 (2008).
Medline CASGoogle Scholar
4. Vos T, Flaxman A, Naghavi M et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859), 2163–2196 (2012).
MedlineGoogle Scholar
5. Kotlarz H, Gunnarsson C, Fang H, Rizzo J. Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data. Arthritis Rheum. 60(12), 3546–3553 (2009).
MedlineGoogle Scholar
6. Torio CM, Moore BJ. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013. 204.
Google Scholar
7. Shin CS, Lee JH. Arthroscopic treatment for osteoarthritic knee. Knee Surg. Relat. Res. 24(4), 187–192 (2012).
MedlineGoogle Scholar
8. Figueroa D, Calvo R, Villalon I et al. Clinical outcomes after arthroscopic treatment of knee osteoarthritis. Knee 20(6), 591–594 (2013).
MedlineGoogle Scholar
9. Jackson RW, Dieterichs C. The results of arthroscopic lavage and debridement of osteoarthritic knees based on the severity of degeneration: a 4- to 6-year symptomatic follow-up. Arthroscopy 19(1), 13–20 (2003).
MedlineGoogle Scholar
10. Forster MC, Straw R. A prospective randomised trial comparing intra-articular Hyalgan injection and arthroscopic washout for knee osteoarthritis. Knee 10(3), 291–293 (2003).
Medline CASGoogle Scholar
11. Zietz PM, Selesnick H. The use of hylan G-F 20 after knee arthroscopy in an active patient population with knee osteoarthritis. Arthroscopy 24(4), 416–422 (2008).
MedlineGoogle Scholar
12. Heng BC, Cao T, Lee EH. Directing stem cell differentiation into the chondrogenic lineage in vitro. Stem Cells 22(7), 1152–1167 (2004).
MedlineGoogle Scholar
13. Mackay AM, Beck SC, Murphy JM et al. Chondrogenic differentiation of cultured human mesenchymal stem cells from marrow. Tissue Eng 4(4), 415–428 (1998).
Medline CASGoogle Scholar
14. Shirasawa S, Sekiya I, Sakaguchi Y et al. In vitro chondrogenesis of human synovium-derived mesenchymal stem cells: optimal condition and comparison with bone marrow-derived cells. J. Cell. Biochem. 97(1), 84–97 (2006).
Medline CASGoogle Scholar
15. McAlindon T, LaValley M, Harvey W et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: a randomized clinical trial. JAMA 317(19), 1967–1975 (2017).
Medline CASGoogle Scholar
16. Hart L. In knee OA, intraarticular triamcinolone increased carilage loss and did not differ from saline for knee pain. Ann. Intern. Med. 167(6), 27 (2017).
Google Scholar
17. Saltychev M, Mattie R, McCormick Z, Laimi K. The magnitude and duration of the effect of intraarticular corticosteroid injections on pain severity in knee osteoarthritis: a systematic review and meta analaysis. Am. J. Phys. Med. Rehabil. 99(7), 617–625 (2020).
MedlineGoogle Scholar
18. Lin K, Yang C, Hsu C, Yeh M, Renn J. Intra-articular injection of platelt-rich plasma is superior to hyaluronic acid or saline solution in the treatment of mild to moderate knee osteoarthritis: randomized, double-blind, triple-parallel, placebo controlled clinical trial. Arthroscopy 35(1), 106–117 (2019).
MedlineGoogle Scholar
19. Bannuru R, Vaysbrot E, Sullivan M, McAlindon T. Relative efficacy of hyaluronic acid in comparison with NSAIDs for knee osteoarthritis: a systematic review and meta-analysis. Semin. Arhtritis Rheum. 43(5), 593–599 (2014).
Medline CASGoogle Scholar
20. Thomas T, Amouroux F, Vincent P. Intra articular hyaluronic acid in the management of knee osteoarthritis: pharmaco-economic study from the perspective of the national health insurance system. PLOS One 12(3), e0173683 (2017).
MedlineGoogle Scholar
21. Neustadt D. Long-term efficacy and safety of intra-articular sodium hyaluronate (Hyalgan) in patients with osteoarthritis of the knee. Clin. Exp. Rheumatol. 21(3), 307–311 (2003).
Medline CASGoogle Scholar
22. Bayliss L, Culliford D, Monk A et al. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. The Lancet 389(10077), 1424–1430 (2017).
MedlineGoogle Scholar

Vol. 18, No. 11

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History

Received 28 June 2023

Accepted 31 October 2023

Published online 21 November 2023

Published in print November 2023

Information

Keywords

Author contributions

A Pearl: data collection, original drafting, editing; K Saleh: data collection, editing; D Korsog: editing; J Mundt: editing.

Financial disclosure

This study was funded by Spartan Medical and Ranfac Corporation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

VA disclosure

This project was supported by the VA. However, the views and content of this article do not necessarily represent the views and opinions of the VA.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

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