Injectable therapies for knee osteoarthritis

Abstract

Knee osteoarthritis is a degenerative arthritis that mainly affects older adults. Over time, osteoarthritis can result in significant and sustained discomfort, pain, and disability. Current treatment focuses on the alleviation of pain and functional impairment. While arthroplasty is the definitive management option, it subjects patients to surgical complications, and the possibility of surgical revisions. In addition, many patients are not surgical candidates. Instead, pharmacological therapy is recommended first-line for most patients. On top of pharmacological therapy, there are a range of non-operative procedural options available. However, leading professional guidelines vary in their recommendations for these agents. <br /> Therefore, we present a review of recent randomized controlled trials and meta-analyses on injectable corticosteroids, hyaluronic acid (HA), platelet-rich plasma (PRP), mesenchymal stem cell injections, and ozone therapy. The preliminary data reveal the strongest evidence in favour of corticosteroid injections, although there are promising findings regarding the long-term efficacy of HA and PRP.

Improvement in condition specific and generic quality of life outcomes in patients with knee osteoarthritis following single intraarticular viscosupplementation injection

“…RAND SF 36 consists of 8 scaled scores namely: Physical function (10), Role limitation due to physical health problem (4), Role limitation due to emotional problem (3), Energy/Fatigue (4), Emotional well-being (5), Social functioning (2), Bodily Pain (2), General Health Perceptions (5) and Health change (1). It has a total of 36 questionnaires which will be pooled to form these eight domains.…”

“…Intra-articular administration of drugs has been considered as a preferred treatment modality due to their promising long-term efficacy. 1 At present, there are numerous non-invasive treatment approaches with emphasis on pain management, improvement in function, and a potential to modify the disease process and progress of cartilage degeneration.…”

“…5 In contrast, others have noted that among the intraarticular injection therapy for knee OA, the evidence was strongly favouring corticosteroids with promising results for HA and PRP. 1 When it comes to the effectiveness of intra-articular injections of Hyaluronic acid in OA knee, several study trials have been done, but the results have been variable. 6…”

Chondrogenic Differentiation of Human Wharton’s Jelly and Bone Marrow-Derived Mesenchymal Stem Cells: Focus on the Role of an Acrylamide-Free Cross-Linked Hyaluronic Acid Hydrogel

“…At present there are no effective treatments for OA and the only available approaches have the scope to alleviate pain and improve daily functioning in OA patients [2]. These include physical therapy, weight loss, lifestyle changes, surgical options (such as arthroplasty) and intra-articular injections of anti-inflammatory compounds, such as corticosteroids and Hyaluronic Acid (HA) [3]. HA is an endogenous high-molecularweight biopolymer produced by the type B synoviocytes and synovial fibroblasts.…”