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Bone Marrow Aspirate Concentrate for Treatment of Primary Knee Osteoarthritis: A Prospective, Single-Center, Non-randomized Study with 2-Year Follow-Up

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Abstract

Introduction

Knee osteoarthritis (OA) is a widespread, disabling condition with no intervention to fully restore cartilage or halt progression. Bone marrow aspirate concentrate (BMAC), an autologous product from bone marrow aspiration, has shown promise as a regenerative therapy due to its cell composition and chondrogenic effects. Our study aims to assess the functional outcomes, including pain, function, satisfaction, and complications post-BMAC injection in knee OA patients.

Materials and Methods

In this prospective, single-center study, 63 patients with grade II–III knee OA (Kellgren–Lawrence (K–L) scale) unresponsive to conservative management underwent BMAC injection. The procedure involved bone marrow aspiration from the anterior iliac crest, processing to obtain a concentrate, followed by intra-articular injection. Patients were followed for 24 months, assessing outcomes using the Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC) score, and MOCART 2.0 score.

Results

The cohort, with a slight female predominance and predominantly aged 41–50 years, majorly comprised K–L grade III OA patients. BMAC treatment resulted in significant improvements in VAS pain scores, IKDC functional scores, and MOCART 2.0 scores over the 24-month follow-up.

Conclusion

BMAC injection provides significant improvement in both pain and functional outcomes at mid-term follow-up in patients with mild-to-moderate OA of the knee. Further high-quality, adequately powered, multi-center, prospective, double-blinded, randomized controlled trials with longer follow-up are necessary to justify the routine clinical use of BMAC for treatment of patients suffering with knee OA.

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Data Availability

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Authors and Affiliations

  1. Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, 600077, India

    Madhan Jeyaraman & Naveen Jeyaraman

  2. Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, 201310, India

    Madhan Jeyaraman & Saurabh Kumar Jha

  3. Clinical Research Associate, Virginia Tech India, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, 600095, India

    Madhan Jeyaraman

  4. South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX, 78045, USA

    Madhan Jeyaraman & Ashim Gupta

  5. Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu, 600002, India

    Swaminathan Ramasubramanian

  6. Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, 201306, India

    Rajni Ranjan

  7. Department of Zoology, Kalindi College, University of Delhi, New Delhi, 110008, India

    Saurabh Kumar Jha

  8. Regenerative Orthopaedics, Noida, Uttar Pradesh, 201301, India

    Ashim Gupta

  9. Future Biologics, Lawrenceville, GA, 30043, USA

    Ashim Gupta

  10. BioIntegrate, Lawrenceville, GA, 30043, USA

    Ashim Gupta

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  1. Madhan Jeyaraman
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Contributions

Conceptualization: Jeyaraman M; data collection: Jeyaraman M, Jeyaraman N, and Ranjan R; manuscript writing: Jeyaraman M and Ramasubramanian S; manuscript revision: Gupta A; proof reading: Jeyaraman M, Jha SK, and Gupta A; administration: Jha SK; and supervision: Gupta A.

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Correspondence to Ashim Gupta.

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This article does not contain any studies with human or animal subjects performed by the any of the authors.

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The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of School of Medical Sciences and Research, Sharda University (Ref no. SU/SMS&R/76-A/2021/113).

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Jeyaraman, M., Jeyaraman, N., Ramasubramanian, S. et al. Bone Marrow Aspirate Concentrate for Treatment of Primary Knee Osteoarthritis: A Prospective, Single-Center, Non-randomized Study with 2-Year Follow-Up. JOIO (2024). https://doi.org/10.1007/s43465-024-01168-6

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