Orthobiologic Treatment for Knee Osteoarthritis: A Cost Effectiveness Choice
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 12, Issue 3
Abstract
Osteoarthritis (OA) is the most prevalent joint disease and a common cause of joint pain, functional loss, and disability. Besides focusing only on pain relief, conventional treatments have shown some serious adverse effects, especially with the use of corticosteroids. In the severe cases of OA, the prosthetic joint replacement is necessary. Thus, the OA treatment represents important economic consequences. In this way, orthobiologics are emerging as an alternative option for the treatment of knee osteoarthritis as they promote tissue regeneration. It comprises intra-articular injections of Platelet Rich Plasma, bone marrow aspirate concentrate, biofat and expanded stem cells. There has been an increasing interest in this approach over the years. Clinical trials using orthobiologics showed that when this therapy is used alone or in combination it is safe and effective in pain relief and function improvement. In addition, several in vitro studies have shown its regenerative properties. The goal of this article is to review the current options in this approach and its fundamental aspects, focusing on costs, mechanisms of action and reports of clinical trials.Knee Osteoarthritis (OA) is one of the most prevalent joint diseases in the world. Its pathology is characterized by progressive degeneration of cartilage and bone tissue, leading to the appearance of subchondral cysts and formation of osteophytes [1,2]. Aetiological factors are also joint specific, in this context, knee OA is a major cause of pain and locomotor disability worldwide. Thus, knee OA patients are subject to functional loss that leads to a reduced quality of life [3]. The epidemiology of the disorder is multifactorial, however, the main risk factors for knee OA are overweight and obesity, previous knee injuries and female gender [3]. Besides that, the increasing of life expectancy and population aging are associated with the increased of OA incidence [4]. Beyond the personal and social consequences, the lower-limb OA, specifically hip and knee OA may have various economics consequences for patients and burdens for patients health systems in worldwide [4]. In Knee OA patiets incurred total of $9,466 annual medical costs and $2,086 annual pharmacy cost, moreover these patients had at least 1 primary knee arthroplasty with costs around $17,433 per surgery [5]. The pathogenesis of knee OA is complex and age-related. In involves chondrocytes’ poor response to growth factors, impaired bio-mechanical properties of articular cartilage, mitochondrial dysfunction, and oxidative stress. Also, a low-grade inflammation plays its role as a key mediator [6].
Authors and Affiliations
Jose Fabio Santos Duarte Lana, Renato Bevilacqua de Castro, Bruno Lima Rodrigues, Carolina Caliari Oliveira, Stephany Cares Huber, Nelson Foresto Lizier, William D Murrel, Mathew Nicholls
Keywords
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- EP ID EP586983
- DOI 10.26717/BJSTR.2018.12.002243
- Views 155
- Downloads 0
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