Current treatments for osteoarthritis with this knee (OAK) are weak. They provide symptom relief only , nor restore articular cartilage.
This absolutely excerpt from a presentation at the rear of American College of Rheumatology meeting by using an ultrasound-guided procedure using autologous mesenchymal stalk cells, growth factors, and set fat matrix (GMSCL).
The working hypothesis was: autologous stem cells from bone marrow absolutely stimulated to grow cartilage if provided with...
• A proper scaffold
• Autologous enlargement stimulating factors
• Limited weight-bearing
Our patient profile listed the following...
• 25 patients
• 36-64 years because of age
• 16 men; 6 women
• BMI: 21-36. 1
• Kellgren-Lawrence golfing lessons:
o 6 grade 2
o 10 seal 3
o 6 grade 4
In mix, patients were given next instructions...
• No NSAIDS (oral and topical) with the month prior and a month post
• No fish oil regarding your month prior and one month post
• May continue precautionary baby aspirin
• No intraarticular injections of any type 1 month prior or during 12 months follow up.
Our procedure tend to be analogous to "Preparing a bit of a Garden"
• Sixty cc's marrow enhanced posterior iliac crest (5 cc's peel cell concentrate~ 6 billion dollars stem cells)- "seeds"
• Sixty cc's peripheral blood for coming of platelet -rich plasma (5 cc's)- "fertilizer"
• Fifteen cc's fat in the abdomen or flank- "soil"
Ultrasound directed fenestration was performed regarding patients.
• Purpose: bring about acute inflammatory response
• Joint capsule sites
- shared line
- adductor tubercle
- medial patellar facet
Regional treatment of fenestrated areas and joint was pursued by direct ultrasound-guided instillation with regard to...
• Stem cells
• Platelet-rich plasma
• Subcutaneous fat
• Calcium supplements chloride/thrombin
Post-procedure, patients were given next instructions...
• Non-weight-bearing for just two weeks
• Limited weight-bearing with prop up that unloads affected compartment for 4 to 6 weeks
A summary of our results is as follows...
Data Available
• 11 People at 6 months
• 10 People at 12 months
Treatment failures
• Four patients
• Defined as patients supply of electricity clinical improvement after attempt months
Two other "failures"
• One person died of an not related illness
• One person lived over the top away to come back
Five 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= 06. 71
SEM= 5. 57
? 12 Months= -25. 2
SD= 26. 94
SEM= 8. 20
Patient It feels like Assessment
? 6 Months= -33. 0
SD= twenty four hours. 13
SEM= 8. 05
? 12 Months= -33. 1
SD= 20. 04
SEM= 6. 35
Patient 50 Feet Walk Pain
? 6 Months= -26. 3
SD= 15. 54
SEM= five. 91
? 12 Months= -16. 7
SD= 12. 05
SEM= five. 01
Physician Global Assessment
? 6 Months= -51. 2
SD= 21 years of age. 60
SEM= 6. 83
? 12 Months= -53. 0
SD= twenty four hours. 15
SEM= 8. 54
Placebo power? Probably not...
Example having to deal with Celebrex vs placebo over OA trials
Mean composite WOMAC report (pain, stiffness, physical function) equals -5. 7 (-7. 5 to go into -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 rating of patello-femoral cartilage denseness at 7 standardized points
• Arm flexed to 90 degrees
• Comparable sites matched for accuracy
• Five measurements every place for reproducibility
• High and low dropped difficult three middle averaged
Ultrasound sized of patello-femoral cartilage thickness at 7 standardized points
• Mean improvement from baseline to few months (11 pts) - 0. five mm
• Mean improvement from baseline to 12 months (10 pts) - 0. 8 mm
Conclusion
While it becomes an uncontrolled study, GMSCL demonstrates some promise to overcome OAK. Further study weighs in at recommended
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