Current Treatments for OsteoArthritis of each knee (OAK) are lack of. They provide symptom relief only and don't restore articular cartilage.
This is an excerpt from a presentation upon the American College of Rheumatology meeting within ultrasound-guided procedure using autologous mesenchymal base cells, growth factors, and one fat matrix (GMSCL).
The installed and operating hypothesis was: autologous stem cells from bone marrow is advised stimulated to grow cartilage if available with...
• A proper scaffold
• Autologous development stimulating factors
• Limited weight-bearing
Our patient profile consisted of the following...
• 22 patients
• 36-64 years produced by age
• 16 men; 6 women
• BMI: 21-36. 1
• Kellgren-Lawrence type:
o 6 grade 2
o 10 secondary 3
o 6 grade 4
In appointment time, patients were given has been instructions...
• No NSAIDS (oral and topical) to begin with month prior and 30 days post
• No fish oil begin with month prior and 1 month post
• May continue preventive baby aspirin
• No intraarticular injections of any kind 1 month prior or during 1 year follow up.
Our procedure could possibly be analogous to "Preparing a greater Garden"
• Sixty cc's marrow got posterior iliac crest (5 cc's set up cell concentrate~ 6 billion stem cells)- "seeds"
• Sixty cc's peripheral blood for advent of platelet -rich plasma (5 cc's)- "fertilizer"
• Fifteen cc's fat via abdomen or flank- "soil"
Ultrasound well-advised fenestration was performed in all patients.
• Purpose: incite acute inflammatory response
• Joint capsule sites
- answered back line
- adductor tubercle
- medial patellar facet
Regional Treatment d from fenestrated areas and joint was and direct ultrasound-guided instillation of...
• Stem cells
• Platelet-rich plasma
• Subcutaneous fat
• Calcium chloride/thrombin
Post-procedure, patients were given has been instructions...
• Non-weight-bearing for two weeks
• Limited weight-bearing with brace that unloads affected compartment for four to six weeks
A summary of our results is as follows...
Data Available
• 11 Men and women at 6 months
• 10 Men and women at 12 months
Treatment failures
• Four patients
• Defined as patients devoid of any clinical improvement after a couple of months
Two other "failures"
• A single person died of an irrelevant illness
• One person lived very good away to come back
Five end users haven't hit the four month mark
WOMAC
? 6 Months= -19. 9
SD=17. 92
SEM= 5. 67
? 12 Months= -7. 9
SD= 9. 97
SEM= 3. 15
Patient VAS Pain
? 6 Months=-33. 7
SD= 16. 71
SEM= 5. 57
? 12 Months= -25. 2
SD= 25. 94
SEM= 8. 20
Patient It seems like Assessment
? 6 Months= -33. 0
SD= 24. 13
SEM= 8. 05
? 12 Months= -33. 1
SD= 19. 04
SEM= 6. 35
Patient 50 Forefoot Walk Pain
? 6 Months= -26. 3
SD= 15. 54
SEM= 4. 91
? 12 Months= -16. 7
SD= 12. 05
SEM= 4. 01
Physician Global Assessment
? 6 Months= -51. 2
SD= 21. 60
SEM= 6. 83
? 12 Months= -53. 0
SD= 24. 15
SEM= 8. 54
Placebo have an effect on? Probably not...
Example of each Celebrex vs placebo in the least OA trials
Mean composite WOMAC rank (pain, stiffness, physical function) equals -5. 7 (-7. 5 to do so -3. 9)
[Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, et al. Treatment of OsteoArthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial.Mayo Clin Proc 1999;74: 1095-1105; Zhao SZ, McMillen JI, Markenson JA, Dedhiya SD, Zhao WW, Osterhaus JT, et al.Evaluation of the functional status aspects of health-related quality of life of patients with OsteoArthritis treated with celecoxib. Pharmacotherapy 1999;19: 1269-1278].
Ultrasound calculate of patello-femoral cartilage wider at 7 standardized points
• Knee flexed to 90 degrees
• Exact same sites matched for accuracy
• Five measurements every point for reproducibility
• High and low dropped in which three middle averaged
Ultrasound live of patello-femoral cartilage thick at 7 standardized points
• Mean improvement from baseline to 6 months (11 pts) - 0. 4 mm
• Mean improvement dependant upon baseline to 12 awhile (10 pts) - 0. 8 mm
Conclusion
While it is an uncontrolled study, GMSCL demonstrates some promise lastly Treatment for OAK. Extras study is recommended
.
No comments:
Post a Comment