Use of autologous conditioned serum (Orthokine) for the treatment of the degenerative osteoarthritis of the temporomandibular joint. Review of the literature

Abstract

Objectives: Treatment of osteoarthritis (OA) using autologous conditioned serum (ACS) has become in recent years an alternative to consider in the approach of the degenerative joint disease of the knee. There is no support in the literature for the use of ACS for the treatment of OA of the temporomandibular joint (TMJ), although the promising results obtained in human patients with knee joint disease as well as in animal studies are opening the way for its use at the TMJ. The aim of this paper is to conduct a review of the published literature regarding the use of the ACS for the treatment of OA in humans, considering the level of scientific evidence, and following the principles of the evidence-based medicine and dentistry. Material and Methods: A PubMed-MEDLINE search was carried out of articles published between 1980 and 2011. After an initial search, a total of 102 articles were obtained, followed by a selection of the most relevant articles according to the topic; a total of 8 articles were selected, which were stratified according to their level of scientific evidence using SORT criteria (Strength of Recommendation Taxonomy). Results: At the time of this review, there is no available literature referring the use of ACS at the TMJ. However, the use of the ACS in other joints is well documented, both experimentally and clinically, in humans and animals. The reviewed articles, with a level of evidence 1 and 2 according to the SORT criteria, have generally promising results. Discussion and Conclusions: The use of ACS in the treatment of OA in joints other than the TMJ, is endorsed by the level of evidence found in the literature, which opens the door to future studies to determine the feasibility of the use of the ACS in the treatment of degenerative OA that affects TMJ. Key words:Osteoarthritis, temporomandibular joint, autologous conditioned serum.

Current Understanding of Pathogenesis and Treatment of TMJ Osteoarthritis

“…PRP can improve bone formation in surgically induced severe degenerative changes of TMJ in rabbits but shows no marked effect on repairing cartilage degradation, and the long-term benefits remain unclear (Kütük et al 2014). Autologous conditioned serum (ACS) as a source of IL-1 receptor antagonist (IL-1Ra) promotes the repair of cartilage and subchondral bone of the knee joint and is an alternative therapy for degenerative joint disease of the knee; however, no reports exist on the use of ACS in the TMJ (Alvarez-Camino et al 2013). The effect of ACS on TMJOA warrants evaluation because IL-1β also plays an important role in the initiation and progression of TMJOA.…”

Use of Autologous Serum in Treatment of Lumbar Radiculopathy Pain. Pilot Study

“…The literature furnishes extensive evidence of effec tive use of the Orthokine therapy in degenerative changes of the knee, where it successfully inhibits the inflammatory response of the joint in the form of effusion and synovial membrane proliferation and effects a considerable reduction in pain in follow-up periods lasting up to 2 years [7,8,9,10].…”

“…Due to the very high concentration of growth factors, the method is useful in the treatment of intramuscular injuries, elbow enthesopathy, rotator cuff and Achilles tendon tendinopathy and even in the symptomatic treatment of inflammation of small joints of the hands, feet or the temporomandibular joint [13].…”

“…W li te ra tu rze opi sa no licz ne do wo dy efek tyw nego sto so wa nia te ra pii Or tho ki ne w przy pad ku zmian zwy rod nie nio wych sta wu ko la no we go, gdzie z powo dze niem ha mu je re ak cję za pal ną sta wu pod po sta cią wy się ku, roz ro stu bło ny ma zio wej i zna czą co re du ku je ból w okre sie ob ser wa cji na wet do 2 lat [7,8,9,10].…”

“…Dzię ki bar dzo du żej kon cen tra cji czyn ni ków wzro stu, me toda spraw dza się w le cze niu uszko dzeń śród mię śnio -wych, en te zo pa tii w ob rę bie sta wu łok cio we go, tendo pa tii ścię gien sto żka ro ta to rów sta wu bar ko we go i ścię gna Achil le sa, a na wet w ob ja wo wej te ra pii zapa leń drob nych sta wów rąk, stóp czy sta wu żu chwowo -skro nio we go [13].…”