PANLAR Consensus Recommendations for the Management in Osteoarthritis of Hand, Hip, and Knee

Rillo, Oscar; Riera, Humberto; Acosta, Carlota; Liendo, Verónica; Bolaños, Joyce; Monterola, Ligia; Nieto, Edgar; Arape, Rodolfo; Franco, Luisa; Vera, Miguel; Papasidero, Sílvia; Espinosa, R.; Esquivel, Jorge; Souto, Renée; Rossi, César; Molina, José Fernando; Salas, José; Ballesteros, Francisco; Radrigán, Francisco; Guibert, Marlene; Reyes, Gil; Chico, Araceli; Camacho, Walter; Urioste, Lorena; Garcia, A; Iraheta, Isa; Gutiérrez, Carmen E.; Aragón, Raúl; Duarte, Margarita; Gonzalez, Margarita; Castañeda, Oswaldo; Angulo, J Carlos; Coimbra, Ibsen Bellini; Muñoz-Louis, Roberto; Saénz, Ricardo; Vallejo, Carlos; Briceño, Julio; Acuña, Ramón Pérez; León, Aníbal de; Reginato, Anthony M.; Möller, Ingrid; Caballero, Carlo; Quintero, Maritza

doi:10.1097/rhu.0000000000000449

Cited by 77 publications

(101 citation statements)

References 125 publications

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“…Currently, no conventional or pharmacological therapies have demonstrated unequivocal efficacy in halting disease progression and injections of molecular compounds to assist healing, such as corticosteroids, may only have placebic pain reducing effects [16][17][18]. Surgical interventions may be beneficial when mechanical deformity is present; however, therapeutic benefit is limited to late-stage OA and is not considered as a long-term solution.…”

Section: Introductionmentioning

confidence: 99%

Intraarticular injection of bone marrow-derived mesenchymal stem cells enhances regeneration in knee osteoarthritis

Doyle

Wragg

Wilson

2020

Knee Surg Sports Traumatol Arthrosc

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Purpose This review aimed to evaluate the efficacy of intra-articular injections of bone marrow derived mesenchymal stem cells (BM-MSCs) for the treatment of knee osteoarthritis (KOA). Methods This narrative review evaluates recent English language clinical data and published research articles between 2014 and 2019. Key word search strings of ((("bone marrow-derived mesenchymal stem cell" OR "bone marrow mesenchymal stromal cell" OR "bone marrow stromal cell")) AND ("osteoarthritis" OR "knee osteoarthritis")) AND ("human" OR "clinical"))) AND "intra-articular injection" were used to identify relevant articles using PMC, Cochrane Library, Web Of Science and Scopus databases. Results Pre-clinical studies have demonstrated successful, safe and encouraging results for articular cartilage repair and regeneration. This is concluded to be due to the multilineage differential potential, immunosuppressive and self-renewal capabilities of BM-MSCs, which have shown to augment pain and improve functional outcomes. Subsequently, clinical applications of intra-articular injections of BM-MSCs are steadily increasing, with most studies demonstrating a decrease in poor cartilage index, improvements in pain, function and Quality of Life (QoL); with moderate-to-high level evidence regarding safety for therapeutic administration. However, low confidence in clinical efficacy remains due to a plethora of heterogenous methodologies utilised, resulting in challenging study comparisons. A moderate number of cells (40 × 10 6 ) were identified as most likely to achieve optimal responses in individuals with grade ≥ 2 KOA. Likewise, significant improvements were reported when using lower (24 × 10 6 ) and higher (100 × 10 6 ) cell numbers, although adverse effects including persistent pain and swelling were a consequence. Conclusion Overall, the benefits of intra-articular injections of BM-MSCs were deemed to outweigh the adverse effects; thus, this treatment be considered as a future therapy strategy. To realise this, long-term large-scale randomised clinical trials are required to enable improved interpretations, to determine the validity of efficacy in future studies. Level of evidence IV.

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Section: Introductionmentioning

confidence: 99%

Intraarticular injection of bone marrow-derived mesenchymal stem cells enhances regeneration in knee osteoarthritis

Doyle

Wragg

Wilson

2020

Knee Surg Sports Traumatol Arthrosc

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“…5 Currently, no traditional or drug therapy has been shown to explicitly block the progression of OA. [6][7][8] Surgical intervention may be beneficial when mechanical malformations are present. However, the benefits are limited to advanced OA, and are not considered a long-term solution.…”

Section: Introductionmentioning

confidence: 99%

<p>Salidroside Alleviates Cartilage Degeneration Through NF-κB Pathway in Osteoarthritis Rats</p>

Gao¹,

Lü

Li³

et al. 2020

DDDT

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Introduction: Osteoarthritis (OA) is the most common disease, which seriously affects the daily life of the elderly. Currently, no traditional or drug therapy has been shown to explicitly block the progression of OA. Salidroside (Sal) is a bioactive component of Rhodiola rosea, which has many beneficial effects on human health. However, the role and mechanism of Sal in OA have not been reported. Methods: We established an anterior cruciate ligament transection (ACLT)-induced OA Rat model. The rats were divided into five groups (n = 10): Control group; ACLT group; ACLT + Sal (12.5 mg/kg) group; ACLT + Sal (25 mg/kg) group; ACLT + Sal (50 mg/kg) group. Results: The study showed that Sal could significantly promote the proliferation of chondrocytes in OA rats induced by ACLT and restore the histological alteration of cartilage. Besides, Sal upregulated the levels of Collagen II and Aggrecan, and downregulated the level of MMP-13. Furthermore, Sal could reduce the number of CD4+IL-17 + cells and decrease the levels of IL-17, IKBα and p65, while elevating the number of CD4+IL-10 + cells and the level of IL-10. The decrease of IL-17 further inhibited the dissociation of IKBα to p65, thus reducing the release of TNF-α and VCAM-1. Taken together, Sal alleviates cartilage degeneration through promoting chondrocytes proliferation, inhibiting collagen fibrosis, and regulating inflammation and immune responses via NF-κB pathway in ACLT-induced OA Rats. Discussion: Collectively, our study investigates the role and mechanism of Sal in OA, which lays a foundation for the application of Sal in OA.

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“…is recommended in the management of symptomatic knee OA, for appropriate patients, by many scholarly societies of rheumatology and orthopedics, 5,8,9 sport medicine, 10 and geriatrics, 11 and is generally considered as an efficient and reliable therapy as evidenced by recent systematic reviews and meta-analyses. [12][13][14][15][16][17][18] Beyond its clinical efficacy in appropriate patients, it has also been suggested that repeat IA injections of HA may sometimes delay the time to arthroplasty.…”

mentioning

confidence: 99%

EUROVISCO Recommendations for Optimizing the Clinical Results of Viscosupplementation in Osteoarthritis

et al. 2018

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Objectives The 3 aims of the work were to identify population subgroups that can benefit the most from viscosupplementation (VS), to provide recommendations on injection techniques, and to discuss VS appropriateness in clinical situations that are commonplace in daily practice. Methods The task force members voted on their degree of agreement on 27 statements, 36 recommendations, and 22 clinical scenarios using a 9-point scale. The strength of agreement/appropriateness/recommendation (SOA/SOR) was classified as strong if the median agreement score was ≥8. The level of consensus (LOC) was also obtained. Results Among the assumed predictors for VS failure, obesity, radiographic severity, large synovial fluid effusion, severe patellofemoral involvement, major malalignment, and gross joint instability received a large majority of agreements. The lateral mid-patellar approach was recommended for knee injection. Imaging guidance was unanimously recommended for hip and ankle. Agreement was achieved to strictly respect the dosing regimen proven by controlled trials. There was agreement for treating with VS patients with mild to moderate knee and hip OA, with normal weight or moderate overweight, insufficiently improved by first-line therapies, or who do not wish get oral treatment or who have contraindications to pain killers. The group considered the patient's wishes as a key element in therapeutic decision making. Conclusion Based on literature data and clinical experience, the EUROVISCO group proposed a set of recommendations for optimizing the results of VS, aimed to help practitioners, especially in some cases in which the patients' specificities make the therapeutic decision difficult.

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PANLAR Consensus Recommendations for the Management in Osteoarthritis of Hand, Hip, and Knee

Cited by 77 publications

References 125 publications

Intraarticular injection of bone marrow-derived mesenchymal stem cells enhances regeneration in knee osteoarthritis

Intraarticular injection of bone marrow-derived mesenchymal stem cells enhances regeneration in knee osteoarthritis

<p>Salidroside Alleviates Cartilage Degeneration Through NF-κB Pathway in Osteoarthritis Rats</p>

EUROVISCO Recommendations for Optimizing the Clinical Results of Viscosupplementation in Osteoarthritis

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