Yibing Li, MD, Katherine Cazilas, PA-C, MPAS, Jeffrey Xue, Leah Tabor, BS, Christina Luncsford (Physical medicine and rehab center, Peoria, IL).
Patients: 10 patients ages 51 to 69, 5 female, 5 male
Case Description:Ligament laxity and cartilage degeneration are root causes of osteoarthritis. Dextrose prolotherapy (prolo), platelet rich plasma (PRP) and autologous stem cell injections into the joints and surrounding weak tendons and ligaments are effective treatments for severe osteoarthritic conditions. Mesenchymal stem cells (MSCs) from bone marrow aspirate with PRP and prolo were used for 10 patients diagnosed with severe osteoarthritis, degenerative joint disease (DJD), ligament laxity and tendinopathy by X-ray and ultrasound or MRI, designed as alternative treatments to total joint replacements. 7 knees, 2 wrists, 1 ankle and 2 hips were injected with this protocol. Outcomes measured: subjective pain, function, ultrasound/MRI and radiographs.
Results: 2 months after 1 bone marrow stem cell/PRP/prolotherapy treatment, 3 patients reported 75-100% pain relief with improved function, 3 patients between 50-75%, 1 patient between 25-50%, 1 patient < 25% and 2 patients results pending. Imaging compared with initial diagnostic scans all showed new tissue growth after 8 weeks. 1 patient with radiographic evidence of severe hip osteoarthritis prior to injections was negative for DJD on follow up.
Discussion: Comprehensive regenerative therapies are cutting-edge alternatives to invasive orthopedic surgeries after failing traditional non-surgical options. It is safe, cost-effective and low-risk for patients who have severe DJD without the risks and downtime of surgery. Severity of arthritis, previous surgeries, baseline health, and age affect which patients will likely benefitfrom this protocol. Further research with larger patient populations are needed to predict outcomes.
Conclusion: Future follow-up investigations will be completed, addressing additional causes of pain and functional limitations. No patients experienced any adverse reactions during or after injections. All were able to return to work the next day.
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