Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis

<i>Background:</i> In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare...

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Autores principales:	Oliver Dulic, Predrag Rasovic, Ivica Lalic, Vaso Kecojevic, Gordan Gavrilovic, Dzihan Abazovic, Dusan Maric, Mladen Miskulin, Marko Bumbasirevic
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bone marrow aspirate concentrate platelet rich plasma hyaluronic acid knee osteoarthritis regenerative medicine stem cells Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/d6258603433942fbb666745ff40b0df5
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spelling	oai:doaj.org-article:d6258603433942fbb666745ff40b0df52021-11-25T18:18:28ZBone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis10.3390/medicina571111931648-91441010-660Xhttps://doaj.org/article/d6258603433942fbb666745ff40b0df52021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1193https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background:</i> In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare clinical outcomes of knee injections of Bone Marrow Aspirate Concentrate (BMAC), Platelet-rich Plasma (PRP), or Hyaluronic acid (HA) in the OA treatment. <i>Methods:</i> Patients with knee pain and osteoarthritis KL grade II to IV were randomized to receive a BMAC, PRP, and HA injection in the knee. VAS, WOMAC, KOOS, and IKDC scores were used to establish baseline values at 1, 3, 6, 9, and 12 months. All side effects were reported. <i>Results:</i> A total of 175 patients with a knee osteoarthritis KL grade II-IV were randomized; 111 were treated with BMAC injection, 30 with HA injection, and 34 patients with PRP injection. There were no differences between these groups when considering KL grade, BMI, age, or gender. There were no serious side effects. The mean VAS scores after 3, 7, 14, and 21 days showed significant differences between groups with a drop of VAS in all groups but with a difference in the BMAC group in comparison to other groups (<i>p</i> < 0.001). There were high statistically significant differences between baseline scores and those after 12 months (<i>p</i> < 0.001) in WOMAC, KOOS, KOOS pain, and IKDC scores, and in addition, there were differences between these scores in the BMAC group in comparison with other groups, except for the PRP group in WOMAC and the partial IKDC score. There were no differences between the HA and PRP groups, although PRP showed a higher level of clinical improvement. <i>Conclusions</i><i>:</i> Bone marrow aspirate concentrate, Leukocyte rich Platelet Rich Plasma, and Hyaluronic acid injections are safe therapeutic options for knee OA and provide positive clinical outcomes after 12 months in comparison with findings preceding the intervention. BMAC could be better in terms of clinical improvements in the treatment of knee OA than PRP and HA up to 12 months. PRP provides better outcomes than HA during the observation period, but these results are not statistically significant. More randomized controlled trials and high quality comparative studies are needed for direct correlative conclusions.Oliver DulicPredrag RasovicIvica LalicVaso KecojevicGordan GavrilovicDzihan AbazovicDusan MaricMladen MiskulinMarko BumbasirevicMDPI AGarticlebone marrow aspirate concentrateplatelet rich plasmahyaluronic acidknee osteoarthritisregenerative medicinestem cellsMedicine (General)R5-920ENMedicina, Vol 57, Iss 1193, p 1193 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bone marrow aspirate concentrate platelet rich plasma hyaluronic acid knee osteoarthritis regenerative medicine stem cells Medicine (General) R5-920
spellingShingle	bone marrow aspirate concentrate platelet rich plasma hyaluronic acid knee osteoarthritis regenerative medicine stem cells Medicine (General) R5-920 Oliver Dulic Predrag Rasovic Ivica Lalic Vaso Kecojevic Gordan Gavrilovic Dzihan Abazovic Dusan Maric Mladen Miskulin Marko Bumbasirevic Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis
description	<i>Background:</i> In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare clinical outcomes of knee injections of Bone Marrow Aspirate Concentrate (BMAC), Platelet-rich Plasma (PRP), or Hyaluronic acid (HA) in the OA treatment. <i>Methods:</i> Patients with knee pain and osteoarthritis KL grade II to IV were randomized to receive a BMAC, PRP, and HA injection in the knee. VAS, WOMAC, KOOS, and IKDC scores were used to establish baseline values at 1, 3, 6, 9, and 12 months. All side effects were reported. <i>Results:</i> A total of 175 patients with a knee osteoarthritis KL grade II-IV were randomized; 111 were treated with BMAC injection, 30 with HA injection, and 34 patients with PRP injection. There were no differences between these groups when considering KL grade, BMI, age, or gender. There were no serious side effects. The mean VAS scores after 3, 7, 14, and 21 days showed significant differences between groups with a drop of VAS in all groups but with a difference in the BMAC group in comparison to other groups (<i>p</i> < 0.001). There were high statistically significant differences between baseline scores and those after 12 months (<i>p</i> < 0.001) in WOMAC, KOOS, KOOS pain, and IKDC scores, and in addition, there were differences between these scores in the BMAC group in comparison with other groups, except for the PRP group in WOMAC and the partial IKDC score. There were no differences between the HA and PRP groups, although PRP showed a higher level of clinical improvement. <i>Conclusions</i><i>:</i> Bone marrow aspirate concentrate, Leukocyte rich Platelet Rich Plasma, and Hyaluronic acid injections are safe therapeutic options for knee OA and provide positive clinical outcomes after 12 months in comparison with findings preceding the intervention. BMAC could be better in terms of clinical improvements in the treatment of knee OA than PRP and HA up to 12 months. PRP provides better outcomes than HA during the observation period, but these results are not statistically significant. More randomized controlled trials and high quality comparative studies are needed for direct correlative conclusions.
format	article
author	Oliver Dulic Predrag Rasovic Ivica Lalic Vaso Kecojevic Gordan Gavrilovic Dzihan Abazovic Dusan Maric Mladen Miskulin Marko Bumbasirevic
author_facet	Oliver Dulic Predrag Rasovic Ivica Lalic Vaso Kecojevic Gordan Gavrilovic Dzihan Abazovic Dusan Maric Mladen Miskulin Marko Bumbasirevic
author_sort	Oliver Dulic
title	Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis
title_short	Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis
title_full	Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis
title_fullStr	Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis
title_full_unstemmed	Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis
title_sort	bone marrow aspirate concentrate versus platelet rich plasma or hyaluronic acid for the treatment of knee osteoarthritis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d6258603433942fbb666745ff40b0df5
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Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis

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