Bone Marrow Aspirate Concentrate Is More Effective Than Hyaluronic Acid And Autologous Conditioned Serum In The Treatment Of Knee Osteoarthritis: A Retrospective Study Of 505 Consecutive Patients

Featured ApplicationThis study shows differences in the efficacy of hyaluronic acid (HA), autologous conditioned serum (ACS) and bone marrow aspirate concentrate (BMAC) intra-articular injections to improve pain and symptoms of knee OA up to one year after treatment. BMAC treatment gives best results at 12 months and is effective also in the patients with more advanced knee osteoarthritis (OA). The study results will be beneficial in making evidence-based orthopaedic decisions on the method of OA treatment based on the levels of cartilage wear, as no clear guidelines have been provided regarding this issue.The aim of this study was to evaluate and compare the effectiveness of three different intra-articular injective treatments: hyaluronic acid (HA), autologous conditioned serum (ACS) and bone marrow aspirate concentrate (BMAC) for the treatment of knee osteoarthritis (OA). A Level III retrospective comparative clinical study was performed on 505 consecutive patients treated with HA (n = 171), ACS (n = 222) or BMAC (n = 112) for knee OA. The mean patient age was 52 +/- 13 years; 54.5% were males. Collected data included patient demographics, symptoms, visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and radiographic classification of osteoarthritis grade using plain radiographs and advanced imaging. Clinical outcome was assessed at 3 and 12 months post treatment. Significant improvement in VAS and WOMAC was seen for all three treatments at the 3-month follow-up. At 12 months, VAS was improved in all three treatment groups, yet only BMAC sustained the improved WOMAC even in patients with more severe degenerative changes. This study shows that BMAC is more effective than HA and ACS in the treatment of symptomatic knee OA, especially in the patients with more severe degenerative changes.