Autologous conditioned serum: clinical and functional results using a novel disease modifying agent for the management of knee osteoarthritis

Abstract

Objective: The purpose of this study was to investigate the potential ability of autologous conditioned serum (ACS) to decrease pain and improve joint functionality in patients affected by knee osteoarthritis (OA). Methods: Fifteen patients with clinical and radiological signs of OA of the knee were recruited for this study. Each patient received 4 injections of ACS (Orthokine; orthogen, Dusseldorf, Germany) at the site of OA once per week for 4 weeks. Clinical and functional evaluation was performed using the VAS scale for pain, WOMAC scale and KSS functional and clinical scores before the first injection, at one week, at two weeks, at three weeks, at one month and at six months. Statistical analysis was done with the Wilcoxon Signed-Rank Test. Results: Our results show an improvement of all the evaluation scales at 6 months follow-up. Particularly, VAS scales among all patients decreased by 35.8% (p ¼ .00148), KSS functional scores improved by 38.2% (p ¼ .00148), KSS clinical scores improved by 28.9% (p ¼ .00236) and WOMAC scores were reduced by 19.8% (p ¼ .00188). Few adverse effects were observed in our sample. The most common complaint was pain and swelling in the subsequent days after performing the intraarticular injection. Only one patient reported rigidity following the injection of the ACS. Conclusion: Our results, in conjunction with preexisting studies in the medical literature regarding ACS, demonstrate the viability of this therapy for the treatment of knee OA, showing positive influence on pain and joint function without significant adverse effects.

Pain control and functional improvement in patients treated by autologous conditioned serum after failure of platelet rich plasma treatments in knee osteoarthritis

“…Overall, the present study indicates and confirms that ACS is a safe and effective treatment for knee OA; 9,16,17 particularly, it is able to rescue a good proportion of patients from orthopaedic surgery, once medical and PRP treatments have failed. On the other hand, to widen these results to the general population of patients with knee OA, as well as to replace PRP treatment with ACS after failure of standard medical interventions, larger controlled studies are required to confirm our encouraging data and to determine whether ACS may be a standard of treatment when current medical treatments fail.…”

Autologous Conditioned Serum Applications in the Treatment of Musculoskeletal Diseases: a Narrative Review

“…Their study as others mentioned above revealed significant improvement in both clinical and functional scales after the intervention. Despite few adverse effects (pain and swelling and one case of joint rigidity after injection), the authors suggested ACS as a safe and tolerable as well as effective therapeutic intervention for knee OA [ 31 ]. In another research conducted in Egypt, Fathalla et al investigated the effectiveness of IA ACS in 30 patients with knee OA (KL grade I–III) and reported significant improvement in all WOMAC scores, which persisted until the third month of follow up [ 32 ].…”

Moving toward targeting the right phenotype with the right platelet-rich plasma (PRP) formulation for knee osteoarthritis

“…Likewise, Orthokine® uses a special syringe containing CrSO4-treated grade glass beads in order to promote IL-1Ra synthesis and accumulation (currently marketed as Orthogen® AG, Düsseldorf, Germany). 15 , 38 …”

“…12,13 Furthermore, novel blood-derived products specific for OA are emerging. 14,15 However, clinical response varies enormously between patients, probably because OA involves different etiologies and pathogenic mechanisms, and thus an array of mixed phenotypes. Which patients are the best candidates for blood-derived therapies thus remains to be elucidated.…”