Bone marrow aspirate in the treatment of osteoarthritis
Osteoarthritis (OA) is a chronic, degenerative process of the hyaline cartilage resulting from aging, repetitive activity and in some cases prior trauma. Knee OA is a significant health problem with increasing impact on public health. For several decades, research has continued to grow in this area. Due to potential therapeutic benefits of bone marrow-derived mesenchymal stem cells (MSCs), multiple researchers started exploring its safety and efficacy to treat joint disorders, including OA.
Bone marrow aspirate concentrate (BMAC) has emerged as a novel treatment for knee pathology. It is a non-surgical regenerative treatment for various orthopedic injuries, including moderate to severe osteoarthritis and tendon injures. BMAC is a concentrate of regenerative stem cells obtained from a patient's own bone marrow. The physician removes a small amount of the patient's bone marrow and spins it in a centrifuge to generate a powerful concentrate that is injected into the injured area.
A trial was conducted to investigate the use of bone marrow concentrate to treat knee OA. Total 25 patients were involved with bilateral knee pain from bilateral OA. They were administered with BMAC into one knee and saline placebo into the other. About 52 ml of bone marrow was aspirated from the iliac crests which was concentrated with aid of an automated centrifuge. Resulting BMAC was mixed with platelet-poor plasma for an injection into arthritic knee and was compared with a saline injection into the contralateral knee, thereby utilizing each patient as his or her own control.
There were no adverse events. It is found that Osteoarthritis Research Society International (OARSI) and visual analog scale scores in both knees decreased significantly from baseline at 1 week, 3 months, and 6 months and pain relief did not differ significantly between treated knees. Early clinical results revealed that Bone marrow aspirate concentrate is safe and is a reliable and viable cellular product. Moreover, participants of study reported similar pain relief in both groups. Furthermore, much research is needed to evaluate the potential mechanisms of pain relief, duration of efficacy, optimal frequency of treatments as well as regenerative potential.