Evaluation of the autologous conditioned serum in the treatment of osteoarthritis

Yıl 2019, Cilt: 4 Sayı: 2, 94 - 98, 01.08.2019

Bekir Eray Kılınç , Yunus Öç

https://doi.org/10.25000/acem.569936

Cited By: 5

Öz

Aim: The
present study was a retrospective study aiming to determine the effect of the autologous
conditioned serum (ACS) on osteoarthritis (OA); we made this analysis by
injecting it to a symmetrically involved knee.

Methods: The present
study comprised 33 patients (19 females, 14 males) with 66 knees and a mean age
of 57.6±8.21 (range: 41-70). The patients included in the study
had radiologically verified bilateral grade 2-3 OA of the knee according to
Kellgren-Lawrence classification. Secondary arthritis, inflammatory
joint diseases, clinically relevant hematologic or abnormal clinical chemistry
values, joint instability, intra-articular corticosteroid injection within the
previous 6 months, history of diabetes mellitus and body mass index greater
than 30 kg/m² were the exclusion criteria. Patients who had VAS
difference more than 2 points between their knees were excluded from the study.
ACS was injected twice a week for a total of 6
times in both knee joints for 3 weeks. The
patients were analyzed with the Visual Analog Scale (VAS) (no pain was
graded 0 and maximal pain was graded 10), the
Knee Injury and Osteoarthritis Score (KOOS) (scoring ranges between 0
and 100. 0 indicates abnormally high level of knee problems, while 100
indicates a healthy knee with no problems) and
the Knee Society Score (KSS) (Of the maximum 100 points, a possible 50
points are assigned to pain, 25 points to stability, and 25 points for range of
motion) before the administration of the first
injection and again 1 year after the last injection.

Results: The
pre-treatment and 1-year follow-up VAS values ​​of the patients were 7.36±0.93 (range: 5-9) and 3.27±1.23 (range: 1-6), respectively. ACS treatment showed a statistically
significant decrease in VAS score (p <0.01). Pre-treatment and 1-year
follow-up KOOS values ​​of the patients were 42.39±13.38 (range: 21-65) and 72.36±8.81 (range: 54-92), respectively. There was a
statistically significant increase in the KOOS values of the patients (p
<0.01). The pre-treatment and 1-year follow-up KSS values ​​of the patients
were 42.79±10.26 (range: 14-61) and 70.61±9.32
(range: 49-84), respectively. There was a
statistically significant increase in the KSS values of the patients (p
<0.01).

Conclusion: Intra-articular injection of ACS in patients with painful OA
leads to significant improvements in pain severity, KOOS, KSS and DCS scores. In
the light of these findings, ACS treatment may be considered as an effective
and safe alternative treatment method in osteoarthritis.

Anahtar Kelimeler

Intra-articular injection, autologous conditioned serum, knee osteoarthritis

Osteoartrit tedavisinde otolog zenginleştirilmiş serumun değerlendirilmesi

Öz

Amaç: Çalışmamızda
retrospektif olarak otolog zenginleştirilmiş serum (OZS) tedavisinin osteoartritteki
etkisinin bilateral diz enjeksiyonu ile değerlendirilmesi amaçlanmıştır.

Yöntemler:
Çalışmamıza yaş ortalaması 57.6 ± 8.21 yıl (41-70) olan 33
hasta (19 kadın, 14 erkek) 66 diz dahil edilmiştir. Çalışmamıza katılan
hastaların diz osteoartritleri Kellgren-Lawrence sınıflamasına göre bilateral
olarak evre 2-3 idi. Sekonder artrit, enflamatuar eklem hastalıkları, klinik
olarak ilgili hematolojik veya anormal klinik kimya değerleri, eklem
instabilitesi, son 6 ay içerisinde eklem içi kortikosteroid enjeksiyonu
uygulanan, diabetes mellitus öyküsü, 30 kg/m²'dan büyük vücut kitle indeksi mevcut olan hastalar
çalışmadan dışlandı. Her iki diz arasındaki VAS farklılığı 2 puandan fazla olan
hastalar çalışmadan çıkarıldı. Üç hafta boyunca haftada iki kez toplamda 6 kez her
iki diz eklem içine OZS enjekte edildi. Hastalar VAS ağrı skorlaması (hiç ağrı
olmaması 0 olarak ve maksimum ağrı 10 olarak derecelendirildi), Diz Yaralanması
ve Osteoartirit Skalası (DYOS) (puanlama 0 ile 100 arasında değişmektedir. 0
anormal derecede yüksek diz problemleri gösterirken, 100 problemsiz sağlıklı
bir diz göstermektedir) ve Diz Cemiyeti Skorlaması (DCS) (Maksimum 100 puan
olan skala ağrıya 50, stabiliteye 25 ve eklem hareket açıklığına 25 puan
atanır) skalaları ile ilk enjeksiyon öncesi ve son enjeksiyondan 1 yıl sonra
değerlendirildi.

Bulgular: Hastaların
tedavi öncesi ve 1. yıl takip VAS değerleri sırası ile 7.36±0.93 (aralık: 5-9) ve 3.27±1.23 (aralık:
1-6) idi. OZS tedavisi VAS skorunda
istatistiksel olarak anlamlı düşme göstermiştir (p<0.01). Hastaların tedavi
öncesi ve 1. yıl takip DYOS toplam değerleri sırası ile 42.39±13.38 (aralık:
21-65) ve 72.36±8.81 (aralık: 54-92) idi. Hastaların
DYOS total skorunda istatistiksel olarak anlamlı yükselme saptanmıştır
(p<0.01). Hastaların tedavi öncesi ve 1. yıl takip DCS değerleri sırası ile 42.79±10.26
(aralık: 14-61) ve 70.61±9.32 (aralık: 49-84) idi. Hastaların DCS değerlerinde istatistiksel olarak anlamlı yükselme saptanmıştır
(p<0.01).

Sonuç:
Ağrılı diz osteoartriti olan hastalarda inra-artiküler OZS kullanımı ağrı
şiddeti, DYS, DYOS ve DCS skorları açısından anlamlı iyileşmelere yol
açmaktadır. Bu bulgular ışığında, OZS tedavisi osteoartritte etkili ve güvenli
bir alternatif bir tedavi yöntemi olarak değerlendirilebilir.

Anahtar Kelimeler

intra-artiküler enjeksiyon, otolog zenginleştirilmiş serum, diz osteoartriti, diz osteoartriti

Kaynakça

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