Therapeutic Effects of Bone Marrow Aspiration Injection for Refractory Osteoarthritis of the Knee: A Case Series

Case Diagnoses: This case series includes 3 cases of patients with refractory osteoarthritis of the knee who have received bone marrow aspirate concentrate injections in office.

Case Description:

The case series examines the patient's perception of pain, symptoms, activities of daily living, sports/recreation, and quality of life following bone marrow aspirate concentrate injections used to treat osteoarthritis of the knee. Osteoarthritis is a challenge to treat and can be an indication for knee replacement when pain persists after treatments with available therapies. Bone marrow aspirate concentrate injection is a type of therapy that uses regenerative cells found in the patient’s own bone marrow. Bone marrow is extracted from the pelvis of the patient, then placed into a centrifuge to separate regenerative cells from the other blood products. The bone marrow is then injected into the knee.

The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to evaluate each patient's perception of pain, symptoms, activities of daily living, sports/recreation, and quality of life. The survey was administered retrospectively, and patients were asked to complete the survey based on their perceptions before and after receiving the injection. The score is calculated on a scale of 0 to 100, with 0 representing extreme problems and 100 representing no problems.

Results/Discussion:

The KOOS scores for each patient were calculated before the injection and after the injection. On average, the results of the case series showed 53% decrease in pain, 70% decrease in symptoms, 36% improvement in activities of daily living, 150% improvement in sports/recreation, and 132% improvement in qualities of life. All 3 cases reported an increased score in each of the 5 measured outcomes. While this is a small case series with only 3 cases, it shows promising results. These patients have also shown clinical improvement following the injection, which correlates well with the improvements in KOOS score. The findings are relevant, as bone marrow aspirate concentrate injections could be an option for patients who desire to avoid knee replacement with refractory osteoarthritis of the knee.

Conclusions:

Based on the results of the case series, bone marrow aspirate concentrate injections may be an appropriate recommendation for patients with refractory osteoarthritis of the knee. More research is indicated in this regard. We are planning to investigate these results further with a cross-sectional descriptive design survey.