Clinical effect of intramuscular calcitonin compared with oral celecoxib in the treatment of knee bone marrow lesions: a retrospective study

Abstract

Background: Bone marrow lesions (BMLs) are a common finding in patients with osteoarthritis (OA), which are predictors of progression and pain related to cartilage damage in OA. The objective of the present research was to compare the short-term clinical effect of intramuscular calcitonin and oral celecoxib in treating knee BMLs. Patients and methods: Between January 2016 and December 2018, the medical records of patients with knee BMLs treated by intramuscular calcitonin or oral celecoxib were reviewed. Visual analog scale (VAS) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to assess knee pain and function, respectively. BMLs were assessed by MRI scans and were scored by the modified Whole-Organ MRI Score (WORMS). The safety of these two medications was also evaluated. Results: A total of 123 eligible patients who received calcitonin treatment (n = 66) or celecoxib treatment (n = 57) were included. All patients were followed up clinically and radiographically for 3 months. The VAS and WOMAC scores were lower statistically in calcitonin group than celecoxib group at 4-week and 3-month follow-up. For BMLs, the WORMS scores in the calcitonin group were significantly lower than the celecoxib group. Besides, statistically higher MRI improvement rates were found in the calcitonin group compared with the celecoxib group at 4-week follow-up (21.21% vs. 7.01%; P = 0.039) and 3-month follow-up (37.88% vs. 15.79%; P = 0.006). Conclusion: Intramuscular calcitonin 50 IU once daily demonstrated a better short-term effect for knee BML patients compared with oral celecoxib 200 mg twice per day.

The Thermosensitive Injectable Celecoxib-Loaded Chitosan Hydrogel for Repairing Postoperative Intervertebral Disc Defect

“…It has a good anti-inflammatory analgesic with the protection of gastric mucosa. However, studies showed that systemic medication can increase the risk of serious cardiovascular thrombotic events including myocardial infarction and stroke for patients with pre-existing cardiovascular disease (Zhou et al, 2020). Some studies have already shown that the local management using celecoxib not only had an anti-inflammatory effect but also avoided the systemic adverse effects (Salgado;Guénée;Černý;Allémann and Jordan, 2020).…”

Subchondral bone as a novel target for regenerative therapy of osteochondritis dissecans: A case report

“…The patient's pain relief seemed to go so far beyond what we would have expected from the MRI improvement that he ultimately decided not to undergo further surgery. Reviewing the literature, we found that BMLs are necrotic and fibrotic according to pathology slides and release inflammatory factors that can cause pain[ 19 , 20 ]. The reduction of the BML areas (the BMLs in front of the femoral condyles have largely disappeared) and fluid was more intuitive than incomplete repair of the cartilage, which may be a function of paracrine cytokines, exosomes, and other active substances of stem cells[ 21 ].…”