Dataset Information

Intraosseous Infiltration of Platelet-Rich Plasma for Severe Hip Osteoarthritis.

ABSTRACT: This work describes a technique of platelet-rich plasma (PRP) infiltration for the treatment of severe hip osteoarthritis (OA). Although the results achieved with intra-articular infiltrations of PRP are promising, they may be insufficient in the long-term for severe hip OA. The technique consists of a combined intra-articular and intraosseous infiltration of PRP to reach all joint tissues, especially the subchondral bone, and hence facilitate a greater distribution of PRP. Diagnosis is based on clinical and radiographic findings, and patients with grade III OA according to the Tönnis scale, as well as patients who have not responded to conventional treatment, are considered candidates for this technique. After an ultrasound-guided intra-articular PRP infiltration is performed, 2 intraosseous infiltrations are conducted with a fluoroscope; the first injection is applied into the acetabulum and the second into the femoral head. However, this technique presents more difficulty than the conventional administration, so it is necessary to consider several aspects described in this work.

SUBMITTER: Fiz N

PROVIDER: S-EPMC5495963 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Intraosseous Infiltration of Platelet-Rich Plasma for Severe Hip Osteoarthritis.

Fiz Nicolás N Pérez Juan Carlos JC Guadilla Jorge J Garate Ane A Sánchez Pello P Padilla Sabino S Delgado Diego D Sánchez Mikel M

Arthroscopy techniques 20170619 3

This work describes a technique of platelet-rich plasma (PRP) infiltration for the treatment of severe hip osteoarthritis (OA). Although the results achieved with intra-articular infiltrations of PRP are promising, they may be insufficient in the long-term for severe hip OA. The technique consists of a combined intra-articular and intraosseous infiltration of PRP to reach all joint tissues, especially the subchondral bone, and hence facilitate a greater distribution of PRP. Diagnosis is based on ...[more]

PMID: 28706837

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Project description:Osteoarthritis (OA) is a debilitating condition that significantly impacts its patients and is closely associated with advancing age and senescence. Treatment with autologous platelet rich plasma (PRP) is a novel approach that is increasingly being researched for its effects. Subchondral bone mesenchymal stromal cells (MSCs) are key progenitors that form bone and cartilage lineages that are affected in OA. This study investigated the changes in subchondral bone MSCs before and after combined intraosseous (IO) and intraarticular (IA) PRP infiltration. Patient bone marrow aspirates were collected from 12 patients (four male, eight female) aged 40-86 years old (median 59.5). MSCs were expanded in standard media containing human serum to passage 1 and analysed for their colony-forming potential, senescence status, and gene expression. Hip dysfunction and Osteoarthritis Outcome Score (HOOS) at baseline and 6 months post second infiltration were used to assess the clinical outcomes; seven patients were considered responders and five non-responders. The number of colony-forming MSCs did not increase in the post treatment group, however, they demonstrated significantly higher colony areas (14.5% higher compared to Pre) indicative of enhanced proliferative capacity, especially in older donors (28.2% higher). Senescence assays also suggest that older patients and responders had a higher resistance to senescent cell accumulation. Responder and non-responder MSCs tended to differ in the expression of genes associated with bone formation and cartilage turnover including osteoblast markers, matrix metalloproteinases, and their inhibitors. Taken together, our data show that in hip OA patients, combined IO and IA PRP infiltrations enhanced subchondral MSC proliferative and stress-resistance capacities, particularly in older patients. Future investigation of the potential anti-ageing effect of PRP infiltrations and the use of next-generation sequencing would contribute towards better understanding of the molecular mechanisms associated with OA in MSCs.

Dataset Information

Intraosseous Infiltration of Platelet-Rich Plasma for Severe Hip Osteoarthritis.

Publications

Intraosseous Infiltration of Platelet-Rich Plasma for Severe Hip Osteoarthritis.

Similar Datasets

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