scholarly journals Biologic Inlay Osteochondral Reconstruction: Arthroscopic One-Step Osteochondral Lesion Repair in the Knee Using Morselized Bone Grafting and Hyaluronic Acid-Based Scaffold Embedded With Bone Marrow Aspirate Concentrate

2017 ◽  
Vol 6 (2) ◽  
pp. e383-e389 ◽  
Author(s):  
Boguslaw Sadlik ◽  
Alberto Gobbi ◽  
Mariusz Puszkarz ◽  
Wojciech Klon ◽  
Graeme P. Whyte
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Bone Grafting ◽  
Bone Marrow Aspirate ◽  
Osteochondral Lesion ◽  
Bone Marrow Aspirate Concentrate ◽  
One Step

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

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1193
Author(s):  
Oliver Dulic ◽  
Predrag Rasovic ◽  
Ivica Lalic ◽  
Vaso Kecojevic ◽  
Gordan Gavrilovic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Side Effects ◽  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Grade Ii

Background: 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. Methods: 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. Results: 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 (p < 0.001). There were high statistically significant differences between baseline scores and those after 12 months (p < 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. Conclusions: 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.

scholarly journals Bone Marrow Aspirate Concentrate for the Treatment of Avascular Meniscus Tears in a One-Step Procedure—Evaluation of an In Vivo Model

2019 ◽  
Vol 20 (5) ◽  
pp. 1120 ◽  
Author(s):  
Matthias Koch ◽  
Selma Hammer ◽  
Julian Fuellerer ◽  
Siegmund Lang ◽  
Christian Pfeifer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Growth Factors ◽  
Bone Marrow Aspirate ◽  
Histological Evaluation ◽  
Bone Marrow Aspirate Concentrate ◽  
Meniscus Suture ◽  
Step Procedure ◽  
Meniscus Tears ◽  
Meniscus Lesions ◽  
One Step

Avascular meniscus tears show poor intrinsic regenerative potential. Thus, lesions within this area predispose the patient to developing knee osteoarthritis. Current research focuses on regenerative approaches using growth factors or mesenchymal stem cells (MSCs) to enhance healing capacity within the avascular meniscus zone. The use of MSCs especially as progenitor cells and a source of growth factors has shown promising results. However, present studies use bone-marrow-derived BMSCs in a two-step procedure, which is limiting the transfer in clinical praxis. So, the aim of this study was to evaluate a one-step procedure using bone marrow aspirate concentrate (BMAC), containing BMSCs, for inducing the regeneration of avascular meniscus lesions. Longitudinal meniscus tears of 4 mm in size of the lateral New Zealand White rabbit meniscus were treated with clotted autologous PRP (platelet-rich plasma) or BMAC and a meniscus suture or a meniscus suture alone. Menisci were harvested at 6 and 12 weeks after initial surgery. Macroscopical and histological evaluation was performed according to an established Meniscus Scoring System. BMAC significantly enhanced regeneration of the meniscus lesions in a time-dependent manner and in comparison to the PRP and control groups, where no healing could be observed. Treatment of avascular meniscus lesions with BMAC and meniscus suturing seems to be a promising approach to promote meniscus regeneration in the avascular zone using a one-step procedure.

scholarly journals Bone Marrow Aspirate Concentrate Is More Effective Than Hyaluronic Acid and Autologous Conditioned Serum in the Treatment of Knee Osteoarthritis: A Retrospective Study of 505 Consecutive Patients

2021 ◽  
Vol 11 (7) ◽  
pp. 2932
Author(s):  
Mohsen Hussein ◽  
Carola F. van Eck ◽  
Nevenka Kregar Velikonja
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Degenerative Changes ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Autologous Conditioned Serum ◽  
Symptomatic Knee ◽  
Comparative Clinical Study

The aim of this study was to evaluate and compare the effectiveness of three different intra-articular injective treatments: hyaluronic acid (HA), autologous conditioned serum (ACS) and bone marrow aspirate concentrate (BMAC) for the treatment of knee osteoarthritis (OA). A Level III retrospective comparative clinical study was performed on 505 consecutive patients treated with HA (n = 171), ACS (n = 222) or BMAC (n = 112) for knee OA. The mean patient age was 52 ± 13 years; 54.5% were males. Collected data included patient demographics, symptoms, visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and radiographic classification of osteoarthritis grade using plain radiographs and advanced imaging. Clinical outcome was assessed at 3 and 12 months post treatment. Significant improvement in VAS and WOMAC was seen for all three treatments at the 3-month follow-up. At 12 months, VAS was improved in all three treatment groups, yet only BMAC sustained the improved WOMAC even in patients with more severe degenerative changes. This study shows that BMAC is more effective than HA and ACS in the treatment of symptomatic knee OA, especially in the patients with more severe degenerative changes.

BONE MARROW ASPIRATE CONCENTRATE INJECTION OF THE ACHILLES TENDON IN A COMPETITIVE DISTANCE RUNNER

2021 ◽  
pp. 2140004
Author(s):  
Kathryn A. Farina ◽  
Blake A. Kandah ◽  
Nan M. Sowers ◽  
Gregory A. Moore
Keyword(s):  
Bone Marrow ◽  
Achilles Tendon ◽  
Bone Marrow Aspirate ◽  
Return To Sport ◽  
Distance Runner ◽  
Complication Rates ◽  
Bone Marrow Aspirate Concentrate ◽  
Progressive Return ◽  
Competitive Athletes ◽  
Lateral Margins

Achilles tendon disorders, including tendinopathy and ruptures, are common among competitive runners. Relatively high complication rates, recurring injuries, and the need to return to sport have led to the use of regenerative medical treatment in tendon disorders in competitive athletes. Biologic therapies, including bone marrow aspirate concentrate (BMAC) injections, have been effective in restoring injured tissue in a limited number of cases. In this case, a collegiate cross country runner with Achilles tendon pain underwent years of failed, non-surgical conservative management. The patient’s MRI demonstrated moderate distal calcaneus tendinosis with high-grade partial thickness tearing of the anterior fibers of the Achilles tendon (50% tear). The patient underwent peritendinous injection of BMAC. Post-procedure MRI demonstrated minimal tendinosis of the distal and lateral margins of the Achilles tendon, and no evidence of Achilles tendon tear. The patient followed a progressive return to running program, ultimately training 40 miles per week with minimal Achilles tendon pain.

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