Rehabilitation following regenerative medicine treatment for knee osteoarthritis-current concept review

McKay, Janine; Frantzen, Kristian; Vercruyssen, Neeltje; Hafsi, Kholoud; Opitz, Tyler J.; Davis, Amelia; Murrell, William

doi:10.1016/j.jcot.2018.10.018

Cited by 14 publications

(11 citation statements)

References 44 publications

(83 reference statements)

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“…6.42 ± 1.68 points at baseline to 1.42 ± 1.77 at 30 days (p=0.0001), 2.74 ± 2.56 at 90 days (p=0.0001 compared to baseline), and 3.26 ± 2.88 after six months (p=0.0001 compared to baseline). The PCPG showed an initial pain level of 5.60 ± 2.11 points.…”

mentioning

confidence: 89%

“…Results of pain and function improvement are more related to exercise than to pharmacological treatments (5). Thus, therapeutic exercise is considered a first-line treatment for OA (6). Exercise intervention for patients with knee OA should be broad and include lower limb strengthening, improving flexibility to reduce stiffness, increasing stability and balance, reducing body weight, in addition to a psychosocial intervention (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, therapeutic exercise is considered a first-line treatment for OA (6). Exercise intervention for patients with knee OA should be broad and include lower limb strengthening, improving flexibility to reduce stiffness, increasing stability and balance, reducing body weight, in addition to a psychosocial intervention (6,7). Type II collagen is the dominant collagen in articular cartilage (8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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Associated Strengthening Exercises to Undenatured Oral Type II Collagen UCII. A Randomized Study in Patients Affected by Knee Osteoarthritis

Costa

Teixeira²,

Pereira³

et al. 2020

Muscle Ligaments and Tendons J

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Background. Osteoarthritis (OA) is a chronic joint disease characterized by progressive degeneration of articular cartilage. It affects 20-25% of the population older than 45 years. The objective was to evaluate the effect of combining muscle strengthening exercises with the administration of oral type II undenatured collagen formulation (UC-II) in people with knee OA. Methods. A double-blind, placebo-controlled, randomized controlled trial with 60 patients with knee OA, randomly divided into the following groups: UC-II and physiotherapy group (CPG), placebo UC-II and physiotherapy group (PCPG), and physiotherapy group (PG). For groups using an oral type II undenatured collagen formulation, UC-II, 40 mg/day UC-II was administered for 90 days. Muscle strengthening exercises were associated with neuromuscular electrical stimulation (NMES), being performed three times a week for 30 days. At 30 and 90 days and six months after the intervention, the following were evaluated: pain, quality of life, functional capacity, muscle strength, and joint mobility. Results. Pain improved in all intervention groups, with no difference between groups. Quadriceps muscle strength increased in the CPG (p<0.005) and PG (p<0.05), the same being observed for active and passive knee flexion mobility (p<0.05). All groups decreased the TUG test execution time after 30 days (p<0.005 for the CPG and PG, and p<0.05 for the PCPG), but only the CPG and PG maintained the scores at 90-day and six-month assessments (p<0.005). Regarding the 6MWT, only the CPG increased the distance covered in all assessments (p<0.005). The PG traveled a greater distance than the PCPG at the 90-day assessment (p<0.05). The WOMAC score decreased significantly in all intervention groups. The Lequesne score decreased in all groups; however, the CPG and PG showed lower values at 30 days (p<0.005). Conclusions. Muscle strengthening exercises improved pain, mobility, strength, and function in knee OA patients. The association of UC-II seems to have accentuated the effect of exercise on this clinical improvement, especially in the long term.

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confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associated Strengthening Exercises to Undenatured Oral Type II Collagen UCII. A Randomized Study in Patients Affected by Knee Osteoarthritis

Costa

Teixeira²,

Pereira³

et al. 2020

Muscle Ligaments and Tendons J

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“…However, while several studies appear to confirm that treatments are safe and efficacious, there are many limitations [91,92]. Generally, the trials are not uniform in terms of patient population, cell source, cell harvest, cell manipulation and number, treatment delivery, time elapsed at follow up, and the approaches utilized to evaluate improvement.…”

Section: Future Perspectivesmentioning

confidence: 99%

Articular Cartilage Regeneration in Osteoarthritis

Roseti

Desando

Cavallo

et al. 2019

Cells

146

103

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There has been considerable advancement over the last few years in the treatment of osteoarthritis, common chronic disease and a major cause of disability in older adults. In this pathology, the entire joint is involved and the regeneration of articular cartilage still remains one of the main challenges, particularly in an actively inflammatory environment. The recent strategies for osteoarthritis treatment are based on the use of different therapeutic solutions such as cell and gene therapies and tissue engineering. In this review, we provide an overview of current regenerative strategies highlighting the pros and cons, challenges and opportunities, and we try to identify areas where future work should be focused in order to advance this field.

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“…Platelet-rich plasma (PRP) is a concentrate of platelets and other components of plasma, which has been widely used in regenerative medicine [1,2,3,4]. The regenerative potential of PRP is based on the release of growth factors that occurs with platelet degranulation.…”

Section: Introductionmentioning

confidence: 99%

Association of Platelet-Rich Plasma and Auto-Crosslinked Hyaluronic Acid Microparticles: Approach for Orthopedic Application

Shimojo

Duarte

Lana³

et al. 2019

Polymers

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Platelet-rich plasma (PRP) associated with high molecular weight hyaluronic acid (HA) has been clinically used for tissue regeneration in orthopedics. Despite the recognized beneficial clinical outcomes (e.g., early pain control, improvement of patients’ functional limitation and longer-term effectiveness compared to PRP and HA alone in mild and moderate osteoarthritis treatments), its use is still challenging and controversial due to lack of standardization of association practical protocols. Moreover, most studies neglect the matrix structure, that generates the ultimate properties of the association among platelets, fibrin network and the microparticles. In the present work, we aimed to analyze the influence of the PRP/HA association with a controlled matrix structure on the stability, rheological behavior, release of growth factors and in vitro proliferation of human adipose-derived mesenchymal cells (h-AdMSCs). The attenuation of the negative charge of HA was also evaluated. Pure PRP (P-PRP) (i.e., plasma enriched with platelets and poor in leukocytes) was prepared by centrifugation and activated with serum and calcium chloride (AP-PRP). Autocrosslinked hyaluronic acid (AHA) was prepared by organocatalyzed auto-esterification and structured in microparticles (MPAHA) by shearing. The attenuation of the negative charge of MPAHA was performed with chitosan (CHT) by polyelectrolyte complexation yielding MPAHA-CHT. The results showed that microparticles (MPs) have viscoelastic properties, extrusion force and swelling ratio appropriate for injectable applications. The association of AP-PRP with the controlled structure of MPAHA and MPAHA-CHT formed a matrix composed of platelets and of a fibrin network with fibers around 160 nm located preferably on the surface of the MPs with an average diameter of 250 μm. Moreover, AP-PRP/MPAHA and AP-PRP/MPAHA-CHT associations were non-toxic and supported controlled growth factor (PDGF-AB and TGF-β1) release and in vitro proliferation of h-AdMSC with a similar pattern to that of AP-PRP alone. The best h-AdMSC proliferation was obtained with the AP-PRP/MPAHA-CHT75:25 indicating that the charge attenuation improved the cell proliferation. Thus, the association of AP-PRP with the controlled structure of HA can be a valuable approach for orthopedic applications.

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Rehabilitation following regenerative medicine treatment for knee osteoarthritis-current concept review

Cited by 14 publications

References 44 publications

Associated Strengthening Exercises to Undenatured Oral Type II Collagen UCII. A Randomized Study in Patients Affected by Knee Osteoarthritis

Associated Strengthening Exercises to Undenatured Oral Type II Collagen UCII. A Randomized Study in Patients Affected by Knee Osteoarthritis

Articular Cartilage Regeneration in Osteoarthritis

Association of Platelet-Rich Plasma and Auto-Crosslinked Hyaluronic Acid Microparticles: Approach for Orthopedic Application

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