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使用骨髓抽吸浓缩物治疗膝骨关节炎:一项系统评价。

Management of knee osteoarthritis using bone marrow aspirate concentrate: a systematic review.

作者信息

Migliorini Filippo, Pilone Marco, Ascani Jacopo, Schäfer Luise, Jeyaraman Madhan, Maffulli Nicola

机构信息

Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Via Lorenz Böhler 5, 39100, Bolzano, Italy.

Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale di San Pio V, 00165 Rome, Italy.

出版信息

Br Med Bull. 2025 Jan 16;153(1). doi: 10.1093/bmb/ldae016.

Abstract

INTRODUCTION

Knee osteoarthritis (OA) is a common degenerative joint condition and a major cause of disability in the general population.

SOURCE OF DATA

Recent published literature identified from PubMed, EMBASE, Google Scholar, and Scopus.

AREAS OF AGREEMENT

Orthobiological therapies try to regenerate articular cartilage and stop the progression of the degenerative lesion. Intra-articular injections of biological derivates have been increasingly used in the last decade.

AREAS OF CONTROVERSY

The indications for the use of bone marrow aspirate concentrate (BMAC) are still unclear.

GROWING POINTS

We systematically reviewed the current literature on BMAC in the management of knee OA, giving an update on the current indications for the selection of the ideal patient and the preparations and efficacy of BMAC compared to other biological alternatives.

AREAS TIMELY FOR DEVELOPING RESEARCH

BMAC is a valuable source of mesenchymal stem cells, offering potential benefits in attenuating the inflammatory pathway associated with knee OA. Intra-articular injection of BMAC has shown effectiveness in clinical trials improving functional outcomes of knee OA patients. The superiority of BMAC over other orthobiological treatments cannot be assessed because of conflicting results.

摘要

引言

膝关节骨关节炎(OA)是一种常见的退行性关节疾病,也是普通人群致残的主要原因。

数据来源

从PubMed、EMBASE、谷歌学术和Scopus中检索到的近期发表的文献。

共识领域

骨科生物治疗旨在使关节软骨再生并阻止退行性病变的进展。在过去十年中,关节腔内注射生物衍生物的应用越来越广泛。

争议领域

骨髓抽吸浓缩物(BMAC)的使用指征仍不明确。

研究热点

我们系统回顾了当前关于BMAC治疗膝关节OA的文献,更新了目前选择理想患者的指征以及BMAC与其他生物替代物相比的制备方法和疗效。

亟待开展研究的领域

BMAC是间充质干细胞的宝贵来源,在减轻与膝关节OA相关的炎症途径方面具有潜在益处。关节腔内注射BMAC在改善膝关节OA患者功能结局的临床试验中已显示出有效性。由于结果相互矛盾,无法评估BMAC相对于其他骨科生物治疗的优越性。

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