Centre of Excellence
For Joint Replacement

Role of biologics in early osteoarthritis knee !

Short Description

The use of biologics to treat certain conditions of tendons, ligaments, cartilage and bones is coming to the forefront of mainstream medicine. Biologic injections may include concentrated amounts of plasma, platelets and stem cells using strong defense systems. Osteoarthritis is a condition that can be treated by biologic injections. This condition is the genetic or traumatic degradation of the cartilage covering the ends of the bones. It can cause pain, joint swelling, joint stiffness and decreased function.

One example of a biologic injection is platelet rich plasma (PRP). Plasma is a component of blood that contains platelets, growth factors and inflammatory mediators. It is a natural source of growth factors involved in the stages of healing. The platelet cells are used for hemostasis, healing promotion and the recruitment other reparative cells. Research has focused on the role PRP and other biologics play in treating osteoarthritis. The early research results for the treatment of osteoarthritis have shown positive results equivalent to or more than other treatment options for longer durations. This treatment is being used worldwide.

PRP is a high concentration of plasma and is obtained by standard  process blood draw from the patient. The blood is then spun down in a centrifuge to separate its contents. A kit containing a special syringe is used to withdraw only the plasma concentrate needed for treatment. This concentrate is then injected into the patient’s joint and the entire process is completed in one visit. Since the source of the blood is from the individual, there is not a risk of rejection or transmission of disease. With any injection, there is a risk of injection site irritation or infection, but these risks are low and complications are rare.

A second type of biologic injection for the treatment of osteoarthritis is stem cell therapy. Stem cells can be harvested from the patient or from a donor. The most common site of harvest to treat an osteoarthritic patient in an outpatient or clinical setting is the patient’s bone or adipose (fat) tissue. The typical area from which bone is harvested is the iliac crest in the pelvis, which can either be retrieved under local anesthetic or sedation prior to surgery of the area being treated. The risk of injection of stem cells is also low, but may come with temporary pain at the harvest site. Other healing factor sources that are more readily available are being researched for possible future treatment.

In day to today practice we are using these therapies in selected patients with early and moderate osteoarthritis grade 2&3 of knee joint but not use in advanced and inflammatory type knee arthritis.  Schedule for three prp injection one for Each month for three months & only 30- 40 % patients get relief . This is not confirm treatment so prior counselling is mandatory .

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