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Treating the Underlying Causes of Synovitis, Degenerative Joint Disease and Osteoarthritis in Primary Care
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
This case demonstrates the importance of taking a thorough history using the FM matrix to help the clinician think critically about the antecedents, triggers and mediators. Laboratory work should be ordered to rule out serious inflammatory disorders and to look for nutritional insufficiencies. Judicious use of radiological tests should also be done to help rule out serious inflammatory joint disorders. This case also demonstrates the therapeutic power of a multifaceted approach focusing on diet and nutrition and a Functional Medicine anti-inflammatory lifestyle as a means to decrease inflammation. This, combined with leading-edge approaches such as autologous conditioned serum, increases the therapeutic efficacy.
Intra-articular injection of platelet-rich plasma in patients with hemophilia and painful knee joint cartilage degeneration
Published in Expert Review of Hematology, 2023
In a network meta-analysis of randomized controlled trials Anil et al evaluated intraarticular injectables: autologous conditioned serum (ACS), bone marrow aspirate concentrate (BMAC), botulinum toxin, corticosteroids, hyaluronic acid, mesenchymal stem cells (MSCs), ozone, saline placebo, PRP, plasma rich in growth factor (PRGF), and stromal vascular fraction (SVF). At 4–6 weeks and 3 months of follow-up, the treatment with the highest P-Score for WOMAC score was high molecular weight (HMW) hyaluronic acid + corticosteroids [P-Score = 0.9500 and 8503, respectively]. At 6-months follow-up, the treatment with the highest P-Score for WOMAC score was PRP [P-Score = 0.7676]. At all postinjection time points, the treatment with the highest P-Score for VAS score [P-Score Range = 0.8631–9927] and WOMAC score at 12 months [P-Score = 0.9044] was SVF. Therefore, this study demonstrated that SVF injections resulted in the greatest amelioration in pain and functional results in individuals with knee osteoarthritis at up to 1 year of follow-up [64].
Autologous conditioned serum for degenerative diseases and prospects
Published in Growth Factors, 2021
Seyed Kazem Shakouri, Sanam Dolati, Jessica Santhakumar, Avnesh S. Thakor, Reza Yarani
Autologous conditioned serum (ACS) was introduced as a new therapeutic agent by Wehling et al. during the mid-1990s (Wehling et al. 2007). ACS is enriched in anti-inflammatory cytokines, including IL-4, IL-10, IL-13, and IL-1Ra, and contains a high concentration of insulin-like growth factor 1 (IGF-1), epidermal growth factor (EGF), hepatocyte growth factor (HGF), transforming growth factor-beta 1 (TGF-β1), vascular endothelial growth factor (VEGF), and fibroblast growth factor (FGF) (Dolati et al. 2020; Tomlinson, Terschuur, and Henson 2021). Because of an increasing request for substitute methods of non-surgical management of degenerative tissue disorders and musculoskeletal conditions, the use of ACS is becoming more common (Hraha et al. 2011). ACS offers a promising interventional orthopedic option since it can inhibit IL-1β through the rapid induction of IL-1Ra (Frisbie 2015). ACS treatment has been shown to improve cartilage integrity by inhibiting inflammatory activity, especially IL-1β mediated inflammation (Rutgers et al. 2010). Even if the composition of ACS would be promising for cartilage regeneration, it is still unknown whether the intra-articularly injected cytokines are existent long enough in the joint to exert their actions (Tatarniuk 2015). In addition, ACS has demonstrated efficacy in the treatment of inflammatory diseases (Genç et al. 2020). Evidence from numerous studies indicates that IL-1β plays a decisive role in the pathophysiology of autoimmune diseases (Kaneko et al. 2019; Mills et al. 2013; Sun et al. 2020). The immunomodulatory properties of ACS may allow for preventive options in the management of autoimmune diseases. In this article, we have reviewed the role of ACS in degenerative joint disease treatment, with a particular focus on its anti-inflammatory effect on muscle injuries, and discussed the possible role of ACS in the treatment of inflammatory and autoimmune diseases.