Regenerative Medicine for Osteoarthritis - The Efficacy and Safety of Intra-Articular orthobiologic Injections: A Literature Review.
The prevalence of progressive joint degradation leading to osteoarthritis (OA) is continuing to rise. Over a sustained period of time the disease progresses and many patients are having to eventually resort surgical intervention to restore the functionality of the affected joint. The current literature review aims to explore two treatment options in regenerative medicine for OA by analysing the efficacy and safety of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) use, as well as determining which population will benefit from these treatments. A total of 1093 patients who were diagnosed with unilateral or bilateral knee osteoarthritis (KOA) were recruited in 23 studies. The groups received either intervention of PRP or MSCs injections in comparison to the control groups receiving either hyaluronic acid (HA) or placebo (saline or dextrose) injections. Medical imaging evaluations (X-ray or MRI) were used to look for structural improvements. In conclusion, both PRP and MSCs treatments were well tolerated, effective and safe to use. Repeated administrations and higher concentrations resulted in superior clinical improvements. A decrease in cartilage loss was observed in some trials. No severe adverse effects were documented. PRP treatment proved to be more efficacious among patients with grade I-II, while MSCs treatment proved to be more beneficial among grade II-III group.
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