TITLE:
Knee Osteoarthritis Treated with Percutaneous Chondral-Bone Interface Optimization: A Pilot Trial
AUTHORS:
Vijay Vad, Raghav Barve, Erica Linnell, Julian Harrison
KEYWORDS:
Osteoarthritis, Stem Cell, Allografts, Chondral-Bone Interface
JOURNAL NAME:
Surgical Science,
Vol.7 No.1,
January
8,
2016
ABSTRACT: Objective: The objective is to evaluate the efficacy of using tibial bone
marrow delivered to the chondral-bone interface (CBI) via percutaneous chondral
bone interface optimization (PeCaBoo) as a therapy for knee osteoarthritis (OA).
Study Design: A series of prospective cases were presented. Participants: Our study
included 10 patients with medial or lateral compartment knee OA. Methods: With 1
cc of heparin pre-loaded in the syringe, 5 cc of tibial bone marrow was withdrawn
from the proximal tibia. The resultant 6 cc of aspirate in the syringe was injected
via PeCaBoo, 2 cc at a time, into the superior CBI and inferior CBI. The remaining
2 cc was injected via needle into the intra-articular joint space. Main Outcome
Measurements: Patients had MRIs taken pre-procedure and 3 months post-procedure
to measure bone edema and intra-articular matrix thickness. Patient-reported outcomes
recorded included the Western Ontario and McMaster University Osteoarthritis Index
(WOMAC) and the Numeric Paint Rating Scale (NRS), which were both obtained pre-procedure and post-procedure at 3, 6, and 12 months.
Use of non-steroidal anti-inflammatories (NSAIDs) was recorded pre- and post-procedure
as well. Results: Our study included 4 males and 6 females, with an average age
of 63.5 years. The average follow-up time was 14 months, with a range of 13 - 15
months. The mean WOMAC score was 58.2 points pre-procedure and 35.3 points post-procedure
(p Boo procedure.
The subgroup of patients with tibial edema and knee OA had optimal outcomes.
Conclusions: Tibial bone marrow stem cell delivered
via PeCaBoo is a novel minimally-invasive treatment for knee OA, with potential
to repair cartilage and improve knee pain and function.