<p>Intra-Articular Injection of Amniotic Membrane and Umbilical Cord Particulate for the Management of Moderate to Severe Knee Osteoarthritis</p>

Abstract

Objective: To evaluate the long-term benefit of a single injection of amniotic membrane/ umbilical cord (AM/UC) particulate in patients with moderate to severe knee osteoarthritis (OA). Methods: A single-center, investigator-initiated, retrospective study of patients who received intra-articular injection of 100 mg lyophilized and micronized AM/UC for radiographically confirmed, Kellgren-Lawrence (KL) grade 3 or 4 symptomatic knee OA. Data regarding demographics, OA severity, comorbidities, treatment regimens, complications, and patient-reported outcomes were collected and assessed. Patient Global Impression of Change (PGIC) was assessed on a 7-point scale, and Global Perceived Improvement (GPI), expressed as percent improvement relative to baseline, was used to further quantify the degree of symptomatic change. Clinically important response to treatment was assessed at 12 months using simplified OMERACT-OARSI responder criteria. Results: A total of 42 patients with KL grade 3 (36%) and 4 (64%) knee OA were included for analysis. Prior to injection, patient-rated pain was 6.6 ± 1.5 out of 10 (median: 7, range: 3-10) despite prior treatment with oral/topical NSAIDs (62%) and intra-articular injection(s) of corticosteroids (57%) and/or hyaluronic acid (48%). Twelve months following AM/UC injection, 31 patients (74%) reported significant clinical improvement via PGIC, and the OMERACT-OARSI treatment response rate was 81% (34/42). GPI of pain and function was 62 ± 24%, 69 ± 27%, 69 ± 27%, and 64 ± 31% at 1, 3, 6, and 12 months, respectively. Symptomatic improvement was maintained for an average duration of 12.1 ± 4.5 months (median: 12, range: 3-22). One patient developed swelling in the knee within 36 hours of injection. No other adverse events or complications were reported. Conclusion: Intra-articular injection of AM/UC particulate may be effective in alleviating pain and improving function in patients with moderate to severe knee OA, with the potential to delay total knee replacement for up to 12 months.

Umbilical Cord–Derived Stem Cells for the Treatment of Knee Osteoarthritis: A Systematic Review

“…Seven studies met inclusion and exclusion criteria ( Figure 1 ), 5 , 6 , 9 , 24 , 26 , 29 , 33 including a total of 385 knees undergoing treatment with hUC-MSCs. Patient age ranged from 29.0 to 94.0 years and the mean follow-up time was 23.4 months (range, 6.0-84.0 months).…”

“…Risk of bias was assessed for 6 studies according to the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool, 34 which incorporates an assessment of bias based on confounding, selection of participants, deviations from intended interventions, completeness of outcome data, selection of outcomes reported, and other sources of bias. 5 , 6 , 9 , 26 , 29 , 33 A Cohen kappa score was calculated to determine the level of intraobserver agreement between reviewers. A score of <0.20 indicated poor agreement; 0.21-0.40, fair agreement; 0.41-0.60, moderate agreement; 0.61-0.80, good agreement; and 0.81-1.00, very good agreement.…”

E Kore Te Tōtara e Tū Noa i Te Pārae, Engari Me Tū i Roto i Te Wao-Nui-a-Tāne: The Symbolism of Rākau and Ngahere in the Huia Short Story Collections

“…As Linda Tuhiwai Smith explains in Decolonizing Methodologies, 109 only Māori people can carry out kaupapa Māori research, but this thesis does not position itself as a work of kaupapa Māori research. There is space for non-Māori academics to contribute to research that can benefit Te Ao Māori without trying to appropriate kaupapa Māori research methodologies.…”

“…Rachel Fabish (anthropology) is currently completing her doctoral research project; this involved establishing and participating in a group of mainly Māori anarchists, using anti-oppressive methodology to discuss the privilege that affected the inner workings of the group and the participants' complaints about the wider anarchist scene. 111 Non-Māori academics who belong to other indigenous cultures, like Chadwick Allen 109 Linda Tuhiwai Smith, Decolonizing methodologies: Research and indigenous peoples, London; New York; Dunedin, Zed Books; University of Otago Press, 1999. 110 Martin Tolich, 'Pākehā "paralysis": Cultural safety for those researching the general population of Aotearoa', Social Policy Journal of New Zealand /Te Puna Whakaaro, 19, (2002), pp.164-178.…”

“…108 Pūriri trees are imbued with the qualities of attractiveness, high status, and amiability in the widely known whakataukī: "Ka kata ngā pūriri o Taiāmai." 109 However, a more wide-ranging study of the pūriri in whakataukī shows that there are several other whakataukī that cast it in an unfavourable light. 110 The end of Everitt's story makes it clear in two ways which traditions it draws from.…”