Clinical Response to Joint Infiltration With Bone Marrow Aspirate in Hip Osteoarthritis: A Systematic Review and Single-arm Meta-analysis.

IF 2.6 2区医学 Q2 ANESTHESIOLOGY

Pain physician Pub Date : 2024-12-01

Michael Silveira Santiago, Fernanda Valeriano Zamora, Elcio Machinski, Andre Richard da Silva Oliveira Filho, Mariana Taina Oliveira de Freitas, Deivyd Vieira Silva Cavalcante, Felipe da Fonseca Delmondes, Rosana Cipolotti

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引用次数: 0

Abstract

Background: Hip osteoarthritis is a joint disease that causes worsening pain and inhibits activities of daily living. Due to poor pain control and the function of usual clinical treatment, joint infiltration with orthobiologics is a therapeutic alternative. Among these, bone marrow aspirate (BMA) represents a cellular therapy with promising clinical results.

Objective: Our study aimed to assess the clinical response of joint infiltration with BMA for hip osteoarthritis.

Study design: We conducted a systematic review and meta-analysis of the main outcomes in hip osteoarthritis after infiltration with BMA and bone marrow concentrate (BMC).

Methods: We systematically searched PubMed, Embase, Cochrane, and Science Direct for studies evaluating patients with hip osteoarthritis who received joint infiltration with BMA or BMC. In the absence of studies with a control group, we performed a pairwise meta-analysis comparing results of a single group at follow-up vs baseline.

Results: We included 4 studies with improvement in Numeric Rating Scale pain scores associated with BMA or BMC therapy at 3 months (mean difference [MD], -3.48 points; 95% CI, -5.81 to -1.15), 6 months (MD, -3.25 points; 95% CI, -4.07 to -2.42), and 12 months (MD, -2.79 points; 95% CI, -3.83 to -1.74). There was also a significant improvement in measurable quality of life through validated questionnaires at 3 months (standardized mean difference [SMD], -0.91; 95%, CI -1.59 to -0.23), 6 months (SMD, -1.38; 95% CI, -1.79 to -0.98), and 12 months (SMD, -1.30; 95% CI, -2.44 to -0.16).

Limitations: Among our study's limitations is the lack of a randomized controlled trial in the meta-analysis. Also, since there was no comparator, we could not conduct a pairwise meta-analysis. Finally, the small sample size limits the generalization of the findings.

Conclusion: In this meta-analysis, joint infiltration with BMA or BMC was associated with an improvement in pain and quality of life in patients with hip osteoarthritis. Further randomized studies are needed to improve the quality of evidence.

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髋关节骨关节炎患者骨髓抽吸关节浸润的临床反应：一项系统综述和单臂荟萃分析

背景：髋关节骨性关节炎是一种关节疾病，可导致疼痛恶化并抑制日常生活活动。由于疼痛控制不佳和常规临床治疗的功能，关节浸润植入骨科是一种治疗选择。其中，骨髓抽吸（BMA）是一种具有良好临床效果的细胞疗法。目的：探讨BMA关节浸润治疗髋关节骨性关节炎的临床疗效。研究设计：我们对BMA和骨髓浓缩物（BMC）浸润后髋关节骨性关节炎的主要结局进行了系统回顾和荟萃分析。方法：我们系统地检索PubMed、Embase、Cochrane和Science Direct，以评估接受BMA或BMC关节浸润的髋关节骨性关节炎患者的研究。在没有对照组研究的情况下，我们进行了两两荟萃分析，比较了单组随访和基线的结果。结果：我们纳入了4项研究，在3个月时BMA或BMC治疗相关的数值评定量表疼痛评分有所改善(平均差[MD]， -3.48分；95% CI, -5.81至-1.15)，6个月(MD, -3.25点；95% CI, -4.07至-2.42)和12个月(MD, -2.79点；95% CI, -3.83至-1.74)。通过3个月的有效问卷调查，可测量的生活质量也有显着改善(标准化平均差[SMD]， -0.91；95%, CI -1.59 ~ -0.23)， 6个月(SMD, -1.38；95% CI, -1.79至-0.98)和12个月(SMD, -1.30；95% CI, -2.44至-0.16)。局限性：本研究的局限性之一是在荟萃分析中缺乏随机对照试验。此外，由于没有比较者，我们无法进行两两荟萃分析。最后，小样本量限制了研究结果的推广。结论：在这项荟萃分析中，BMA或BMC的关节浸润与髋关节骨关节炎患者疼痛和生活质量的改善有关。需要进一步的随机研究来提高证据的质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain physician CLINICAL NEUROLOGY-CLINICAL NEUROLOGY

CiteScore

6.00

自引率

21.60%

发文量

234

期刊介绍： Pain Physician Journal is the official publication of the American Society of Interventional Pain Physicians (ASIPP). The open access journal is published 6 times a year. Pain Physician Journal is a peer-reviewed, multi-disciplinary, open access journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. Pain Physician Journal presents the latest studies, research, and information vital to those in the emerging specialty of interventional pain management – and critical to the people they serve.