Shaw Brent, Darrow Marc, Derian Armen
Darrow Stem Cell Institute, Los Angeles, CA, USA.
Mayo Clinic, Phoenix, AZ, USA.
Clin Med Insights Arthritis Musculoskelet Disord. 2018 Jun 18;11:1179544118781080. doi: 10.1177/1179544118781080. eCollection 2018.
Preliminary research suggests that bone marrow concentrate (BMC), which contains mesenchymal stem cells and platelets, is a promising treatment for knee osteoarthritis. The aim of this study was to build on this preliminary research by reporting the short-term progress of 15 patients (20 knees) with knee osteoarthritis through 4 BMC treatments.
Patients underwent four sequential BMC treatments with mean injection times of 13.80 days after the first treatment, 21.40 days after the second treatment, and 33.50 days after the third treatment. The last follow-up was conducted a mean 86 days after the first treatment. Baseline and posttreatment outcomes of resting pain, active pain, lower functionality scale, and overall improvement percentage were compared after each treatment.
Patients experienced statistically significant improvements in active pain and functionality score after the first treatment. Additionally, patients experienced a mean decrease in resting pain after the first treatment, yet outcomes were not statistically significant until after the second treatment. On average, patients experienced an 84.31% decrease in resting pain, a 61.95% decrease in active pain, and a 55.68% increase in functionality score at the final follow-up. Patients also reported a mean 67% total overall improvement at study conclusion. Outcomes at the final follow-up after the fourth treatment were statistically significant compared to outcomes at baseline, after first treatment, after second treatment, and after third treatment.
These results are promising, and additional research with a larger sample size and longer follow-up is needed to further examine the treatment effectiveness of multiple BMC injections for knee osteoarthritis.
初步研究表明，含有间充质干细胞和血小板的骨髓浓缩物（BMC）是治疗膝关节骨关节炎的一种有前景的方法。本研究的目的是在这项初步研究的基础上，报告15例（20个膝关节）膝关节骨关节炎患者接受4次BMC治疗后的短期进展情况。
患者接受了4次连续的BMC治疗，首次治疗后平均注射时间为13.80天，第二次治疗后为21.40天，第三次治疗后为33.50天。最后一次随访在首次治疗后平均86天进行。比较每次治疗后静息痛、活动痛、功能较低量表和总体改善百分比的基线和治疗后结果。
首次治疗后，患者的活动痛和功能评分有统计学意义的改善。此外，首次治疗后患者静息痛平均有所减轻，但直到第二次治疗后结果才有统计学意义。在最后一次随访时，患者静息痛平均减轻84.31%，活动痛减轻61.95%，功能评分提高55.68%。患者在研究结束时还报告总体平均改善67%。第四次治疗后最后一次随访的结果与基线、首次治疗后、第二次治疗后和第三次治疗后的结果相比有统计学意义。
这些结果很有前景，需要进行更大样本量和更长随访时间的进一步研究，以进一步检验多次BMC注射治疗膝关节骨关节炎的有效性。
