Joint Preservation Using Orthobiologic Therapies in Osteoarthritis
Syed Asif Hasan *
Department of Orthopaedics, Sameera Medical Center, Jeddah, Saudi Arabia.
Salman Nawaf Almutairi
College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
Lwai Abdullah Alhemaid
Department of Orthopaedics, Qatif Central Hospital, Qatif, Saudi Arabia.
Ahmad Hassan Al Ghazwi
College of Medicine, Istanbul University, Istanbul, Turkey.
Badr Saad Alkhathaami
Department of Anaesthesia, National Guard Health Affairs, Jeddah, Saudi Arabia.
Talal Sulaiman Alrumaihi
Department of Orthopaedics, Almadinah General Hospital, Medina, Saudi Arabia.
Noor Abdullah Altarooti
Department of Orthopaedics, Qatif Central Hospital, Qatif, Saudi Arabia.
Ahmed Suliman Fallatah
College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Omar Samir Moamina
College of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia.
Yasir Abdullah Alkhayri
College of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia.
Majed Abdullah Almutairi
College of Medicine, Qassim University, Qassim, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Osteoarthritis is estimated to be the most prevalent musculoskeletal disorder in the world. Estimates show that the disease is prevalent in 18% and 10% in women and men that are aged >60 years old. The quality of life of the affected patients can also be significantly impacted due to the associated morbidities and functional loss. Many interventions have been proposed to preserve the joint and enhance the functional outcomes in patients with osteoarthritis. In the present literature review, we have discussed the different orthobiologic therapies for patients with osteoarthritis for joint preservation and subsequent improvement in the functional and pain outcomes. Variable modalities that have been proposed in the literature include Bone Marrow Aspirate Concentrate (BMAC), gene therapy and platelet rich plasma (PRP). All of these modalities were reported with favorable outcomes and minimal complications. PRP has been reported to have a clinical efficacy that is boosed when co-administered with hyaluronic acid. However, it should be noted that the clinical efficacy is limited in the long term, and administration is continuously required. On the other hand, gene therapy is a promising technique that offers maintained favorable outcomes with no adverse events. However, further studies are still needed to indicate the effectiveness and cost-efficacy of this approach.
Keywords: Osteoarthritis, orthobiologic, platelet-rich plasma, stem cell therapy, gene therapy, adipose-derived stromal cell therapy