Injections for knee pain: Bone marrow aspirate concentrate vs. PRP

One injection of bone marrow stem cells versus one injection of PRP

A January 2022 study (1) compared bone marrow derived stem cell therapy vs. Platelet Rich Plasma. What the researchers did was give patients with knee pain and functional problems either one injection of bone marrow aspirate concentrate or one injection of Platelet Rich Plasma. The patients were then followed for 12 months to see how this one injection worked out for them and their knee pain.

In this study the researchers explained: “investigational cell therapies injected intra-articularly, such as bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), have shown safety and therapeutic potency providing patients with pain relief. In the current retrospective comparative study, we investigated the differences in pain and functional improvements in patients with symptomatic knee osteoarthritis receiving intra-articular injections of BMAC vs PRP.

Pain and functionality scores were measured at baseline and at different time points post-injection over 12 months, using 3 self-administered, clinically validated questionnaires: the visual analogue scale (VAS) for assessing pain intensity, the knee injury and osteoarthritis outcome score (KOOS) for evaluating functionality and knee-related quality of life, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for evaluating physical function.

The BMAC group significantly improved in VAS, KOOS, and WOMAC scores between baseline and 12 months. In contrast, the PRP group witnessed non-significant improvement in all scores. BMAC, in comparison to PRP, induced significant improvement in outcomes.

Conclusions reached by the research team: “Intra-articular autologous BMAC injections are safe, effective in treating pain, and ameliorate functionality in patients with symptomatic knee osteoarthritis to a greater extent than PRP injections. Intra-articular autologous BMAC therapy is safe and provides more relief to patients with symptomatic knee osteoarthritis compared to PRP therapy.”

Research 2022: PRP injections in the knee can alleviate pain symptoms

Bone marrow derived stem cell injections are considered a more potent treatment, especially true in advanced knee osteoarthritis. However PRP treatments can show good results as well in patients with stage III knee osteoarthritis.

A January 2022 paper (2) evaluated the effect of intraarticular injection with platelet-rich plasma in knee osteoarthritis patients. A total of 250 patients treated with PRP suffering from stage I-III osteoarthritis were included in this study. All the patients had received autologous PRP injection (3 ml) into the affected knee joint every week for totally 3 injections.

The VAS (pain 0-10) score and WOMAC (disability) index were used to evaluate knee function before and at 3 days, 1 month, and 3 months after injection. A total of 250 patients were enrolled in this study, including 130 patients in the PRP group and 120 patients in the control group.

Findings: “The VAS score and WOMAC index of patients in the PRP group before treatment were not significantly different from those in the control group. At 3 days, 1 month, and 3 months after PRP treatment, the VAS score and WOMAC index of the PRP group were significantly lower than those of the control group. PRP is effective in treatment of knee osteoarthritis. The pain symptoms can be alleviated at 3 days after injection.”

1 El-Kadiry AE, Lumbao C, Salame N, Rafei M, Shammaa R. Bone marrow aspirate concentrate versus platelet-rich plasma for treating knee osteoarthritis: a one-year non-randomized retrospective comparative study. BMC Musculoskeletal Disorders. 2022 Dec;23(1):1-4.
2. Zhang B, Yu J, Fan D, Bao L, Feng D. Effect of Intraarticular Injection of Platelet-Rich Plasma on Knee Osteoarthritis: A Multicenter Retrospective Clinical Study. Journal of Healthcare Engineering. 2022 Jan 7;2022.


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