Researchers at the Steadman Clinic and Research Institute in Colorado recently published a pilot study investigating patient reported outcomes in hip pain and function after undergoing a single injection of bone marrow concentrate to the affected joint. As one of the leading causes of disability in the US, patients suffering from moderate to severe hip osteoarthritis who do not respond to conservative treatment may effectively minimize pain and improve overall joint function with the use of bone marrow concentrate as an alternative treatment. Currently, there is no evidence that orthobiologic cell-based therapies can delay joint degeneration in arthritic patients; however, physicians may be interested in treating patients diagnosed with hip osteoarthritis with this alternative therapy to manage symptomatic pain and dysfunction until joint replacement surgery is necessary. Researchers intended to determine the efficacy of bone marrow concentrate to treat symptoms of patients living with hip osteoarthritis.
Patient-reported outcomes were measured using the NRS pain score, a modified Harris Hip Score, the Hip Outcome Score – ADL, a 12-Item Short Form Health survey, a Physical Component Summary, a Mental Component Summary, and the WOMAC index to score baseline, and post-procedural outcomes up to 6 months. The duration of the study was set at 6 months because patients will generally decide to undergo joint replacement surgery by 6 months if the alternative treatments are unsuccessful. Bone marrow aspirate was harvested from the posterior superior iliac crest, processed into a concentrate, and reinjected into the affected hip joint space on the same day within 4 hours of harvesting. Approximately 60-120mL of bone marrow aspirate was harvested and processed to yield a total volume of 6-12mL of bone marrow concentrate. Sample analysis showed higher concentrations of platelets, WBCs, monocytes, and neutrophils, with lower concentrations of RBCs, present in the final bone marrow concentrate compared to levels measured in the initially harvested aspirate. Six to 12mL of bone marrow concentrate was injected into the intra-articular space under ultrasound guidance. Eighteen patients enrolled in the study successfully underwent the injection procedure, of which two participants eventually required joint replacement surgery 4-6 months after their injection. Therefore, a total of 16 patients completed all patient-reported outcome surveys at 6 months post-procedure at the conclusion of the study.
This pilot study showed that a single injection of bone marrow concentrate into the intra-articular space of an osteoarthritic hip resulted in significant pain reduction and joint function at 6-month follow up post-procedure. The most significant finding was that participants who completed the study reported less pain with and without activity as early as 6-weeks post-procedure. Therefore, bone marrow concentrate therapy for the treatment of hip osteoarthritis can improve hip function and reduce pain over 6 months with a single injection. There were no adverse events or complications reported. Further investigation is warranted to evaluate treatment outcomes in a larger sample size, and to compare outcomes against other cell-based therapies. Access the article here.