Intra-Articular Bone Marrow Concentrate Injection Protocol: Short-Term Efficacy in Osteoarthritis

Sampson, Steven; Smith, Jay; Vincent, Hunter; Aufiero, Danielle; Zall, Mona; Botto-van-Bemden, Angie

doi:10.2217/rme-2016-0081

Cited by 39 publications

(32 citation statements)

References 42 publications

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“…Some who may have been early responders may have experienced waning improvement at 1–1.5 year follow‐up. Also of note, the average percent improvement in VAS in the responder cohort was 73%, which is in line with previous findings (71.4%) presented by Sampson et al .…”

Section: Discussionsupporting

confidence: 92%

“…These include vascular endothelial growth factor, transforming growth factor‐β, platelet derived growth factor (PDGF), and interleukin (IL)1‐RA . Furthermore, BMAC has a high concentration of platelets that can decrease pain through peripheral endocannabinoid pathways, the NF‐κB pathway, and through enhancing the production of endogenous hyaluronic acid .…”

Section: Discussionmentioning

confidence: 99%

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Functional Outcomes Following Microfragmented Adipose Tissue Versus Bone Marrow Aspirate Concentrate Injections for Symptomatic Knee Osteoarthritis

Mautner

Bowers

Easley

et al. 2019

Stem Cells Translational Medicine

135

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This study aimed to determine whether autologous orthobiologic tissue source affects pain and functional outcomes in patients with symptomatic knee osteoarthritis (OA) who received microfragmented adipose tissue (MFAT) or bone marrow aspirate concentrate (BMAC) injection. We retrospectively reviewed prospectively collected data from patients who received BMAC or MFAT injection for symptomatic knee OA. Patients completed baseline and follow‐up surveys. Each survey included the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire, Emory Quality of Life (EQOL) questionnaire, and Visual Analog Scale (VAS) for pain. The follow‐up responses were compared with baseline for all patients and between BMAC and MFAT groups. A total of 110 patients met inclusion criteria, with 76 patients (BMAC 41, MFAT 35) and 106 knees (BMAC 58, MFAT 48) having appropriate follow‐up data. The BMAC group included 17 females and 24 males, with a mean age of 59 ± 11 years. The MFAT group included 23 females and 12 males, with a mean age of 63 ± 11 years. Minimum follow‐up time was 0.5 years. Mean follow‐up time was 1.80 ± 0.88 years for BMAC and 1.09 ± 0.49 years for MFAT. Both groups had significant improvement in EQOL, VAS, and all KOOS parameters preprocedure versus postprocedure (p < .001). There was not a significant difference when comparing postprocedure scores between groups (p = .09, .38, .63, .94, .17, .15, .70, respectively). These data demonstrate significant improvement in pain and function with both MFAT and BMAC injections in patients with symptomatic knee OA without a significant difference in improvement when comparing the two autologous tissue sources. Stem Cells Translational Medicine 2019;8:1149–1156

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Functional Outcomes Following Microfragmented Adipose Tissue Versus Bone Marrow Aspirate Concentrate Injections for Symptomatic Knee Osteoarthritis

Mautner

Bowers

Easley

et al. 2019

Stem Cells Translational Medicine

135

View full text Add to dashboard Cite

show abstract

“…In the 30 studies that reported sex ( n = 1975 patients), 1119 patients (56.7%) were female. Twenty-nine studies (82.9%) 5 , 6 , 20 , 23 – 35 , 37 – 48 , 50 reported the radiographic severity of knee OA (i.e., Kellgren/Lawrence [K/L] grade); however, the eligibility criteria of disease severity differed between studies. The final follow-up period was 3–60 months.…”

Section: Resultsmentioning

confidence: 99%

“…Owing to the large clinical and statistical heterogeneity among the studies, we did not pool the adverse event rates. In 10 studies that reported timing of adverse event, 5 , 6 , 31 , 32 , 34 , 37 – 39 , 45 , 50 knee pain or swelling occurred within 1 week after MSC treatment; these symptoms were treatable with pain medication.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of mesenchymal stem cells for treating patients with knee osteoarthritis: a meta-analysis toward the establishment of effective regenerative rehabilitation

et al. 2018

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This systematic review with a meta-analysis aimed to summarize the current evidence of the effectiveness of mesenchymal stem cell (MSC) treatment for knee osteoarthritis (OA) and to examine whether rehabilitation is an effect modifier of the effect estimate of MSC treatment. A literature search yielded 659 studies, of which 35 studies met the inclusion criteria (n = 2385 patients; mean age: 36.0–74.5 years). The meta-analysis results suggested that MSC treatment through intra-articular injection or arthroscopic implantation significantly improved knee pain (standardized mean difference [SMD]: −1.45, 95% confidence interval [CI]: −1.94, −0.96), self-reported physical function (SMD: 1.50, 95% CI: 1.09, 1.92), and cartilage quality (SMD: −1.99; 95% CI: −3.51, −0.47). However, the MSC treatment efficacy on cartilage volume was limited (SMD: 0.49; 95% CI: −0.19, 1.16). Minor adverse events (knee pain or swelling) were reported with a wide-ranging prevalence of 2–60%; however, no severe adverse events occurred. The evidence for these outcomes was “very low” to “low” according to the Grades of Recommendation, Assessment, Development and Evaluation system because of the poor study design, high risk of bias, large heterogeneity, and wide 95% CI of the effects estimate. Performing rehabilitation was significantly associated with better SMD for self-reported physical function (regression coefficient: 0.881, 95% CI: 0.049, 1.712; P = 0.039). We suggest that more high quality randomized controlled trials with consideration of the potential rehabilitation-driven clinical benefit would be needed to facilitate the foundation of effective MSC treatment and regenerative rehabilitation for patients with knee OA.

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“…Rodriguez-Fontan et al 99 reported that minimal clinically important difference (MCID) was achieved in 12 of 19 patients with mild to moderate knee and hip OA, including 10 knees and 15 hips, treated with single BMAC injection at 6 months. Finally, Sampson et al 100 reported patient satisfaction in 90% of patients in a retrospective review of 125 patients with moderate-to-severe OA of primarily the knee, hip, and shoulder treated with a single BMAC injection followed by PRP injection 8 weeks later.…”

Section: Mscs In Osteoarthritismentioning

confidence: 99%

Orthobiologics for the Hip Region: A Narrative Review

McInnis

Chen

Finnoff

et al. 2020

PM&R

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Management of hip region disorders is challenging. Orthobiologic treatments including platelet rich plasma (PRP), mesenchymal stem cells, and amniotic injectables have gained popularity as promising treatments despite a lack of robust evidence for their effectiveness. We review rationale and current evidence for orthobiologics for three common hip region conditions: hip osteoarthritis, gluteal tendinopathy, and proximal hamstring tendinopathy. Overall, the current state of evidence is extremely limited for orthobiologic treatments and is predominantly relevant to PRP injections. There is currently a lack of data to support the use of mesenchymal stem cells or amniotic injectables in these conditions of the hip. the use of orthobiologics in the treatment of three common diagnoses affecting the hip region: osteoarthritis (OA), gluteal tendinopathy, and proximal hamstring tendinopathy (PHT). Methods A review was conducted of PubMed and Medline articles from January 2000 to June 2019 with search terms including hip, osteoarthritis, gluteal tendonitis, hamstring tendonitis, tendinosis, tendinopathy, platelet rich plasma, mesenchymal stem cell, amniotic stem cell, and amniotic injectables. Randomized controlled trials, case series, systematic reviews, and meta-analyses were reviewed. Only studies investigating chronic refractory tendinopathy and osteoarthritis were included. We did not include studies investigating acute muscle, myotendinous injury, acetabular labral pathology, or focal osteochondral lesion. Platelet Rich Plasma PRP is an autologous plasma concentrate containing platelets above physiologic concentrations in whole blood. Platelets are thought to initiate the healing cascade by forming a fibrin matrix, which serves as a tissue

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Intra-Articular Bone Marrow Concentrate Injection Protocol: Short-Term Efficacy in Osteoarthritis

Abstract: Intra-articular injection of BMC, followed by a PRP injection, can provide short-term benefits in moderate-to-severe osteoarthritis.

Cited by 39 publications

References 42 publications

Functional Outcomes Following Microfragmented Adipose Tissue Versus Bone Marrow Aspirate Concentrate Injections for Symptomatic Knee Osteoarthritis

Functional Outcomes Following Microfragmented Adipose Tissue Versus Bone Marrow Aspirate Concentrate Injections for Symptomatic Knee Osteoarthritis

Effectiveness of mesenchymal stem cells for treating patients with knee osteoarthritis: a meta-analysis toward the establishment of effective regenerative rehabilitation

Orthobiologics for the Hip Region: A Narrative Review

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