The use of cellular matrix in symptomatic knee osteoarthritis

Abstract

Knee osteoarthritis is a degenerative "wear and tear" disorder affecting mainly population over 50 years old. It can also present in younger people, especially after an injury or as a part of other diseases. While many therapeutic options exist for knee osteoarthritis, none of them has the potential to cure this condition. Cellular Matrix represents a combination of natural non-crosslinked hyaluronic acid (HA), thixotropic cell separation gel, and sodium citrate anticoagulant solution. A combination of Cellular Matrix with autologous platelet-rich plasma (A-PRP) is a novel therapeutic approach to the management of knee osteoarthritis. It is assumed that the active components HA and PRP have a synergistic effect contributing to a better therapeutic outcome in patients with knee osteoarthritis. Physiotherapy could provide an additional benefit. This is a retrospective pilot study assessing the potential benefit of Cellular Matrix and A-PRP combined with physiotherapy in the management of chronic knee osteoarthritis. Twenty-five patients were enrolled in the study and injected with three doses of Cellular Matrix combined with A-PRP with a time span of 2 weeks between each injection. All patients received standardized physiotherapy. The results showed that 68% of patients achieved more than 50% improvement in pain, stiffness, and function of the knee joints. There were no adverse reactions. This retrospective pilot study confirmed the positive effect of PRP and HA combination in the management of mild and moderate knee osteoarthritis. These preliminary results need to be verified in randomized control trials.

Prospective study comparing leukocyte-poor platelet rich plasma combined with hyaluronic acid and autologous microfragmented adipose tissue in patients with early knee osteoarthritis.

“…All patients received standardized physiotherapy. The results showed that 68% of patients achieved more than 50% improvement in pain, stiffness, and function of the knee joints and there were no adverse reactions 24 . In the PRP-HA group, a cycle consisting of three injections, each given at a monthly interval was performed, and the positive effects of repeated intra-articular PRP injections on clinical outcomes of early knee OA has previously been published 36,37 .…”

“…Total leukocyte concentration was below the normal level-speci c granulocyte depletion >95% (mostly mononuclear cells being recovered 75% lymphocytes; 50% monocytes) in 4 mL of PRP. The system provides a 1,6-1,8 fold increase in platelets [23][24][25] . The PRP was aspirated into a syringe, and a topical anaesthetic skin refrigerant was applied locally before intraarticular in ltration by a supra-patellar approach using sterile aseptic precautions.…”

Raloxifene inhibits the overexpression of TGF-β1 in cartilage and regulates the metabolism of subchondral bone in rats with osteoporotic osteoarthritis

“…The development of OA cannot be stopped [ 33 ]. However, bone metabolism regulators, including SERMs, delay the progression of OA [ 9 , 34 ].…”

A Prospective Study Comparing Leukocyte-Poor Platelet-Rich Plasma Combined with Hyaluronic Acid and Autologous Microfragmented Adipose Tissue in Patients with Early Knee Osteoarthritis

“…A cycle consisted of three injections, given 1 month apart. Six milliliters of blood from the cubital vein was obtained and centrifuged for 5 min at 1,500g relative centrifugal field and 3,500 revolutions per minute as per the manufacturer's recommendations [22]. A mix was prepared of PRP with HA at a concentration of 3 mL of PRP for every 2 mL of HA.…”

“…Total leukocyte concentration was below the normal level-specific granulocyte depletion >95% (mostly mononuclear cells being recovered 75% lymphocytes; 50% monocytes) in 4 mL of PRP. The system provides a 1.6-1.8 fold increase in platelets [22,24,25]. The PRP was aspirated into a syringe, and a topical anesthetic skin refrigerant was applied locally before intra-articular infiltration by a suprapatellar approach using sterile aseptic precautions.…”