P185 - Intra-articular injection of bone marrow concentrate vs hyaluronic acid in bilateral knee osteoarthritis: preliminary results of a RCT
Abstract
Purpose
Knee osteoarthritis represents a very common problem with a high social impact, and a significant amount of patients complain of bilateral symptomatic osteoarthritis. The aim of this study is analyze the preliminary short-term results of double-blind randomized self-controlled trial comparing intra-articular injection of autologous bone marrow concentrate (BMC) versus hyaluronic acid (HA) for bilateral knee osteoarthritis.
Methods and Materials
60 patients with bilateral symptomatic knee osteoarthritis were enrolled. Each patient received a BMC injection (treatment group, n=60 knees) in one knee and an HA injection (control group, n=60 knees) in the other knee. The side of the treatment was randomly assigned. Patients were prospectively followed at 1, 3, 6, 12, and 24 months follow-up visit, using IKDC subjective, VAS, and KOOS scores. MRI was performed at 12 months, and x-rays were performed at 24 months. Three patients were lost to follow-up. Up-to-date 36 patients (36 knees for each groups) were evaluated at 6 months follow-up and were included in the current analysis.
Results
No adverse event was reported in both groups. At the 6 months follow-up, a significant improvement of all clinical scores was found compared to the baseline evaluation in both groups. IKDC subjective score in BMC and HA groups improved from 47.1±14.2 and 49.9±16.2 to 58.5±18.9 and 60.7±21.6 respectively. Similar trends were found for KOOS and VAS scores. Two knees failed 6 months after treatment in BMC group, requiring new injective treatment in one patient and knee arthroplasty in the other one, and one knee failed 6 months after treatment in HA group, requiring new injective treatment.
Conclusion
The results of this study suggest that intra-articular injection of BMC is a safe treatment and can effectively relief pain and improve function up to 6 months follow-up in patients with knee osteoarthritis, without any significant difference compared to HA.
