Do knee Injection Portals Affect Clinical Results of Bone Marrow Aspirate Concentrate Injection in the Treatment of Osteoarthritis? A Prospective Randomized Controlled Study

Dulić, Oliver; Lalić, Ivica; Kecojevic, Vaso; Gavrilovic, Gordan; Abazović, Džihan; Miškulin, Mladen; Marić, D; Bumbaširević, Marko

doi:10.2217/rme-2020-0020

Cited by 6 publications

(1 citation statement)

References 27 publications

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“…BMC is prepared from bone marrow aspirate (BMA) from the iliac crest or other sites; commonly, 60 mL of BMA are harvested to produce 3–6 mL of BMC, commonly through centrifugation. 18 The harvest procedure is relatively invasive: it requires piercing the cortical bone with a trocar, introducing a needle in the medullary canal and aspirating bone marrow in a syringe prefilled with heparin to avoid coagulation. Most cells in BMC are heme progenitors (CD34 + ) and small numbers (0.01–0.001%) of BM-MSCs, much less than SVF (0.01–0.1% AD-MSCs), are obtained.…”

Section: Characteristics Of Regenerative Injectable Productsmentioning

confidence: 99%

Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis

Andı́a

Maffulli

2021

Therapeutic Advances in Musculoskeletal

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Sports injuries and secondary joint problems, mainly of the knee, are common, especially in sports associated with high impact activities and/or torsional loading. The consequences can be career ending in elite athletes and reduce exercise activities in recreational people. Various cell products can be injected intra-articularly. First, fresh cellular mixtures can be prepared and injected in the same day, such as stromal vascular fraction of adipose tissue (SVF) and bone marrow concentrates (BMCs). Second, autologous mesenchymal stromal cells (MSCs) can be isolated from BMCs or SVF and, after several weeks of laboratory expansion, several millions of MSCs can be obtained for intra-articular injection. Finally, allogeneic MSCs from the bone marrow, adipose tissue or perinatal tissues of selected donors constitute an ‘off-the-shelf’ experimental treatment for injection delivery in patients with osteoarthritis of the knee. The perceived efficacy of all these products is based on the hypothesis of a paracrine mechanism of action: when living cells are delivered within the joint, they establish a molecular cross-talk with immune cells and local cell phenotypes, thereby modulating inflammation with subsequent modifications in the catabolic/degenerative milieu. Current clinical research examines whether injection delivery of MSCs translates into actual clinical benefits. Overall, clinical studies lack the quality needed to answer major research questions, including clinical and structural efficacy, optimal cell dose, and number of injections and specific protocol for cell delivery. Poor experimental designs are exacerbated by the diversity of patient phenotypes that hinder comparisons between treatments. Further understanding of disease pathology is paramount to develop potent function assays and understand whether the host tissue, the cell product or both should be primed before MSCs are injected intra-articularly.

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Section: Characteristics Of Regenerative Injectable Productsmentioning

confidence: 99%

Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis

Andı́a

Maffulli

2021

Therapeutic Advances in Musculoskeletal

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Stem Cells Therapy for Cartilage Regeneration in Clinic: Challenges and Opportunities

Shahnazari

Malih

Naeimi

et al. 2023

Cartilage: From Biology to Biofabrication

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The Current Status of Clinical Trials on Biologics for Cartilage Repair and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data

Zhang

Schon

2022

CARTILAGE

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Objective Biologics are increasingly used for cartilage repair and osteoarthritis (OA) treatment. This study aimed to provide an overview of the clinical trials conducted on this subject. Design Two-word combinations of two sets of key words “cartilage”; “joint”; “osteoarthritis” and “biologics”; “stem cells”; “cell implantation” were used to search the database of ClinicalTrials.gov and supplemented with searches of PubMed and EMbase. The registered trials were analyzed for clinical conditions, completion status, phases, and investigated biologics. Recently completed trials with posted/published results were summarized. Results From 2000 to 2022, a total of 365 clinical trials were registered at ClinicalTrials.gov to use biologics for cartilage repair and OA treatment. Since 2006, the number of registered trials accelerated at an annual rate of 16.4%. Of the 265 trials designated with a phase, 72% were early Phase 1, Phase 1, and Phase 2. Chondrocytes and platelet-rich plasma (PRP) were studied in nearly equal number of early- and late-stage trials. Mesenchymal stem/stromal cells (MSCs) were the most commonly investigated biologics (38%) and mostly derived from bone marrow and adipose tissue (70%). In last 5 years, 32 of the 72 completed trials posted/published results, among which seven Phase 3 trials investigated chondrocytes, PRP, bone marrow aspirate concentrate, hyaluronic acid, collagen membrane, and albumin. Conclusions There was a rapid increase in the number of registered clinical trials in recent years, using a variety of biologics for cartilage repair and OA treatment. Majority of the biologics still require late-stage trials to validate their clinical effectiveness.

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Do knee Injection Portals Affect Clinical Results of Bone Marrow Aspirate Concentrate Injection in the Treatment of Osteoarthritis? A Prospective Randomized Controlled Study

Cited by 6 publications

References 27 publications

Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis

Mesenchymal stromal cell products for intra-articular knee injections for conservative management of osteoarthritis

Stem Cells Therapy for Cartilage Regeneration in Clinic: Challenges and Opportunities

The Current Status of Clinical Trials on Biologics for Cartilage Repair and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data

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