Tsitsilianos Nicholas, Shirazi Zainab, Lu Jessica, Singh Jaspal Ricky
Weill Cornell Department Rehabilitation Medicine, USA.
Weill Cornell Medical College, USA.
Interv Pain Med. 2022 Dec 2;1(4):100163. doi: 10.1016/j.inpm.2022.100163. eCollection 2022 Dec.
Bone marrow aspirate (BMA) intra-articular injection is a minimally invasive orthobiologic treatment option for osteoarthritis (OA). Hip OA affects a significant portion of the population and has a paucity of data surrounding orthobiologic treatments. The primary objective of this study was to delineate the clinical impact of bone marrow aspirate intra-articular injections on decreasing pain and improving function in patients with hip OA.
A single-center, retrospective analysis of thirty-one patients, aged 32 to 83 (62.4 ± 16.5), with Kellgren-Lawrence (KL) Hip OA grading of 2-4 (mean 2.9 ± 0.7), who underwent intra-articular bone marrow aspirate injection into the hip and were followed for twelve months. Evaluation was at baseline, 12 weeks, 6 months, and 12 months using the Numerical Rating Scale (NRS) for pain and the Hip Disability and Osteoarthritis Outcome Score Jr (HOOS-Jr) for function. The proportion of responders, as defined by a ≥50% reduction in NRS pain score, was assessed at 12 weeks, 6 months and 12 months.
At 6 and 12 months follow-up, there was a statistically significant improvement in NRS scores (P < 0.05). Stratifying by KL grade, subjects with KL grades 2 and 3 experienced statistically significant improvement in NRS scores at 6 and 12 months. Patients with KL grade 4 showed significant improvement in pain at 12 months. Forty-two percent of patients at 6 months and 61% at 12 months reported ≥50% reduction in pain. When stratifying by KL grade, 80% and 71% of KL2 and KL3 grades respectively were responders by 12 months. Patients experienced statistically significant improvement in HOOS-Jr scores at 6 and 12 months.
In patient with mild, moderate, and severe hip OA, BMA may be an alternative treatment that improves pain and function in patients for as long as 12 months. In addition, BMA may also be an effective, lower cost option to more expensive BMAC preparations.
骨髓抽吸物（BMA）关节内注射是骨关节炎（OA）的一种微创骨科生物治疗选择。髋骨关节炎影响着相当一部分人群，且围绕骨科生物治疗的数据较少。本研究的主要目的是描述骨髓抽吸物关节内注射对减轻髋骨关节炎患者疼痛和改善功能的临床影响。
对31例年龄在32至83岁（平均62.4±16.5岁）、Kellgren-Lawrence（KL）髋关节OA分级为2至4级（平均2.9±0.7级）的患者进行单中心回顾性分析，这些患者接受了髋关节内骨髓抽吸物注射，并随访12个月。在基线、12周、6个月和12个月时，使用数字评分量表（NRS）评估疼痛，使用髋关节残疾和骨关节炎结果评分 Jr（HOOS-Jr）评估功能。在12周、6个月和12个月时，评估疼痛NRS评分降低≥50%定义的反应者比例。
在6个月和12个月的随访中，NRS评分有统计学意义的改善（P<0.05）。按KL分级分层，KL 2级和3级的受试者在6个月和12个月时NRS评分有统计学意义的改善。KL 4级患者在12个月时疼痛有显著改善。6个月时42%的患者和12个月时61%的患者报告疼痛减轻≥50%。按KL分级分层时，到12个月时，KL2级和KL3级分别有80%和71%的患者为反应者。患者在6个月和12个月时HOOS-Jr评分有统计学意义的改善。
对于轻度、中度和重度髋骨关节炎患者，BMA可能是一种替代治疗方法，可在长达12个月的时间内改善患者的疼痛和功能。此外，与更昂贵的骨髓浓缩物（BMAC）制剂相比，BMA可能也是一种有效且成本较低的选择。
