Laboratory of Thrombosis and Hemostasis, Montreal Heart Institute, Research Center, Montreal, QC, Canada.
Department of Biomedical Sciences, Université de Montréal, Montreal, QC, Canada.
BMC Musculoskelet Disord. 2022 Jan 3;23(1):23. doi: 10.1186/s12891-021-04910-5.
Knee osteoarthritis (OA) is a debilitating condition affecting human body biomechanics and quality of life. Current standard care for knee OA leads to trivial improvement and entails multiple adverse effects or complications. Recently, investigational cell therapies injected intra-articularly, such as bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), have shown safety and therapeutic potency providing patients with pain relief. In the current retrospective comparative study, we investigated the differences in pain and functional improvements in patients with symptomatic knee OA receiving intra-articular injections of BMAC vs PRP.
Pain and functionality scores were measured at baseline and at different time points post-injection over 12 months, using 3 self-administered, clinically validated questionnaires: the visual analogue scale (VAS) for assessing pain intensity, the knee injury and osteoarthritis outcome score (KOOS) for evaluating functionality and knee-related quality of life, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for evaluating physical function. The repeated-measures general linear model with Sidak test for pairwise comparisons was used to investigate the influence of the treatment on the score evolution within groups (between baseline and each time point) and between groups (overall).
The BMAC group (n = 26 knees) significantly improved in VAS, KOOS, and WOMAC scores between baseline and 12 months (57.4, 75.88, and 73.95% mean score improvement, respectively). In contrast, the PRP group (n = 13 knees) witnessed nonsignificant improvement in all scores. BMAC, in comparison to PRP, induced significant improvement in outcomes by 29.38% on the VAS scale, 53.89% on the KOOS scale, and 51.71% on the WOMAC scale (P < .002, P < .01, P < .011, respectively).
Intra-articular autologous BMAC injections are safe, effective in treating pain, and ameliorate functionality in patients with symptomatic knee OA to a greater extent than PRP injections. Intra-articular autologous BMAC therapy is safe and provides more relief to patients with symptomatic knee osteoarthritis compared to PRP therapy.
膝骨关节炎（OA）是一种使人衰弱的疾病，会影响人体生物力学和生活质量。目前针对膝骨关节炎的标准治疗方法只能带来微小的改善，并且会带来多种不良反应或并发症。最近，研究性的关节内细胞疗法，如骨髓抽吸浓缩物（BMAC）和富含血小板的血浆（PRP），已显示出安全性和治疗效果，为患者带来了疼痛缓解。在目前这项回顾性比较研究中，我们调查了接受关节内 BMAC 与 PRP 注射治疗的有症状膝骨关节炎患者在疼痛和功能改善方面的差异。
使用 3 种自我管理的、临床验证的问卷，在基线和注射后 12 个月内的不同时间点测量疼痛和功能评分：视觉模拟量表（VAS）用于评估疼痛强度，膝关节损伤和骨关节炎结局评分（KOOS）用于评估功能和与膝关节相关的生活质量，以及西部安大略省和麦克马斯特大学关节炎指数（WOMAC）用于评估身体功能。采用重复测量的一般线性模型和 Sidak 检验进行组内（与基线相比的每个时间点）和组间（总体）比较，以研究治疗对评分演变的影响。
BMAC 组（26 个膝关节）在 VAS、KOOS 和 WOMAC 评分方面从基线到 12 个月时均有显著改善（分别为 57.4%、75.88%和 73.95%的平均评分改善）。相比之下，PRP 组（13 个膝关节）所有评分均未见显著改善。与 PRP 相比，BMAC 在 VAS 评分上引起 29.38%的显著改善，在 KOOS 评分上引起 53.89%的显著改善，在 WOMAC 评分上引起 51.71%的显著改善（P<.002、P<.01、P<.011，分别）。
关节内自体 BMAC 注射是安全的，在治疗疼痛方面有效，并能在更大程度上改善有症状的膝骨关节炎患者的功能，优于 PRP 注射。与 PRP 治疗相比，关节内自体 BMAC 治疗对有症状的膝骨关节炎患者更安全，能提供更大程度的缓解。
