Non-operative Management of Osteoarthritis (OA) of the Knee: What Should you be Injecting Now and in the Future? (AANA19)-Biologics and OA_ What is the Evidence

Video Transcription

Video Summary

The presentation addresses the complexities of using biologics to treat osteoarthritis (OA), focusing on patient selection, biologic types, and safety concerns. It emphasizes identifying OA patients with inflammatory symptoms, as they respond better to treatments like leukocyte-poor platelet-rich plasma (PRP), which has demonstrated efficacy in reducing inflammation. PRP variants, including those combined with anti-inflammatory agents such as alpha-2-macroglobulin or IL-1 receptor antagonists, are discussed for their potential benefits and limitations. Stem cell therapies, primarily from adipose tissue and bone marrow aspirate, are reviewed; adipose-derived cells show higher cell yields and promising clinical results, including cartilage regeneration evidence, whereas bone marrow aspirate requires precise harvesting techniques due to lower cell counts. The safety of various injections is critically examined, warning against chondrotoxic agents like certain local anesthetics (e.g., lidocaine), corticosteroids (notably betamethasone due to toxicity and inflammatory crystal formation), and additives like epinephrine preservatives and Toradol, which harm cartilage. The speaker calls for caution, informed product choice, and targeted biologic use rather than broad application. Despite limited definitive data, emerging research supports significant potential benefits when biologics are applied judiciously in OA treatment.

Asset Caption

Instructional Course Lecture: Non-operative Management of Osteoarthritis (OA) of the Knee: What Should you be Injecting Now and in the Future?

Keywords

osteoarthritis

biologics

platelet-rich plasma

stem cell therapy

inflammation

chondrotoxicity

patient selection