From the Guidelines
Bone marrow injections for knee osteoarthritis are not recommended as a standard treatment option due to limited high-quality evidence supporting their routine clinical use. The current evidence does not provide sufficient support for the use of bone marrow injections as a first-line treatment for knee osteoarthritis, and established treatments such as physical therapy, weight management, oral or topical anti-inflammatories, and corticosteroid or hyaluronic acid injections remain the recommended approaches 1.
Key Considerations
- The procedure involves harvesting bone marrow from the patient's iliac crest under local anesthesia, processing it to concentrate stem cells and growth factors, and then injecting this concentrate into the affected knee joint.
- The theoretical mechanism involves mesenchymal stem cells and growth factors promoting tissue repair and reducing inflammation.
- Patients considering bone marrow injections should be aware that it is often not covered by insurance due to its experimental status, with out-of-pocket costs ranging from $2,000 to $5,000 per treatment.
- Results can vary significantly between individuals, with some experiencing improvement lasting 6-12 months while others see minimal benefit.
Alternative Treatments
- Physical therapy: recommended as a first-line treatment for knee osteoarthritis 1.
- Weight management: sustained weight loss has been shown to benefit pain and function in overweight and obese patients with knee osteoarthritis 1.
- Oral or topical anti-inflammatories: recommended as a first-line treatment for knee osteoarthritis, with oral nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen consistently demonstrating improved pain and function in patients with knee osteoarthritis 1.
- Corticosteroid or hyaluronic acid injections: recommended as a treatment option for knee osteoarthritis, with corticosteroid injections having considerable evidence supporting their use, although the duration of benefits was often only 3 months 1.
Conclusion Not Allowed, so this is just more information
In contrast to bone marrow injections, platelet-rich plasma (PRP) has been shown to reduce pain and improve function in patients with symptomatic osteoarthritis of the knee, although the strength of recommendation is limited 1. However, the use of bone marrow injections is not recommended as a standard treatment option for knee osteoarthritis, and patients should be aware of the limited evidence supporting their use and the potential risks and costs associated with the treatment.
From the Research
Current Recommendations for Bone Marrow Injections in Knee Osteoarthritis
- The use of bone marrow injections to treat osteoarthritis of the knee is a topic of ongoing research, with some studies suggesting its potential effectiveness in improving symptoms and quality of life for patients 2.
- A study published in 2017 found that a single intra-articular injection of bone marrow-derived mononuclear cells resulted in significant improvements in pain and osteoarthritis symptoms compared to hyaluronic acid injections 2.
- Another study published in 2020 discussed the use of biological treatments, including bone marrow mesenchymal stem cells, as a potential option for treating osteoarthritis, highlighting their ability to increase the quality of cartilage in osteoarthritis patients 3.
Comparison with Other Treatments
- A comparison of bone marrow-derived mononuclear cells with hyaluronic acid injections found that the bone marrow-derived mononuclear cells provided better pain relief in the long-term period 2.
- Nonpharmacological and nonsurgical approaches, such as education, exercise, and weight loss, are also recommended as core treatments for osteoarthritis, with bone marrow injections being considered as an additional option 4.
Safety and Efficacy
- The available evidence suggests that bone marrow injections are a safe manipulation with no serious adverse effects observed in the studies 2.
- However, more research is needed to fully understand the efficacy and safety profile of bone marrow injections for the treatment of knee osteoarthritis, as well as to determine their place in the overall management of the condition 5, 6.