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Regenerative Injection Therapy for Osteoarthritis: Fundamental Concepts and Evidence‐Based Review
Author(s) -
Vora Ariana,
BorgStein Joanne,
Nguyen Rosalyn T.
Publication year - 2012
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2012.02.005
Subject(s) - medicine , osteoarthritis , platelet rich plasma , clinical trial , regenerative medicine , ligament , prolotherapy , physical therapy , intensive care medicine , surgery , pathology , stem cell , alternative medicine , platelet , biology , genetics
Regenerative therapy involves the injection of a small volume of solution into multiple sites of painful ligament and tendon insertions (entheses) and adjacent joint spaces, with the goal of reducing pain and ostensibly promoting tissue repair and growth. Dextrose and platelet‐rich plasma solutions have been shown to increase expression of growth factors in vivo and have shown promising clinical results in the treatment of tendinosus. In the treatment of osteoarthritis, small clinical trials and case series to date suggest safety, symptomatic improvement, and functional improvement at up to a year of follow‐up; however, most of these studies are uncontrolled. Given the methodological limitations of clinical research on regenerative injections for osteoarthritis to date, this treatment should be considered only after execution of a comprehensive assessment and treatment plan, including optimization of biomechanics, weight loss, cardiovascular exercise, resistance training, and judicious use of more established topical, oral, and injectable medications.