Soufan S, Al Khoury J, Hamdan Z, Rida MA. Intra-articular interventions in osteoarthritis: Navigating the landscape of hyaluronic acid, mesenchymal stem cells, and platelet-rich plasma. World J Orthop 2024; 15(8): 704-712 [PMID: 39165875 DOI: 10.5312/wjo.v15.i8.704]
Corresponding Author of This Article
Mohamad Ali Rida, MD, Assistant Professor, Department of Internal Medicine, Clemenceau Medical Center, Clemenceau, Beirut 12345, Lebanon. mohamad.ali.rida@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2024; 15(8): 704-712 Published online Aug 18, 2024. doi: 10.5312/wjo.v15.i8.704
Intra-articular interventions in osteoarthritis: Navigating the landscape of hyaluronic acid, mesenchymal stem cells, and platelet-rich plasma
Somar Soufan, Joenne Al Khoury, Zahi Hamdan, Mohamad Ali Rida
Somar Soufan, Joenne Al Khoury, Zahi Hamdan, Department of Medicine, University of Balamand, Beirut 00000, Lebanon
Mohamad Ali Rida, Department of Internal Medicine, Clemenceau Medical Center, Beirut 12345, Lebanon
Author contributions: Soufan S, Hamdan Z and Al Khoury J designed and wrote the manuscript; Soufan S, Hamdan Z, Al Khoury J and Rida MA did the literature review; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mohamad Ali Rida, MD, Assistant Professor, Department of Internal Medicine, Clemenceau Medical Center, Clemenceau, Beirut 12345, Lebanon. mohamad.ali.rida@gmail.com
Received: April 25, 2024 Revised: July 13, 2024 Accepted: July 29, 2024 Published online: August 18, 2024 Processing time: 109 Days and 14.9 Hours
Abstract
Osteoarthritis (OA) poses a substantial burden on patients, leading to pain, functional decline, and reduced quality of life. While conventional treatments focus on symptom management, disease-modifying interventions are yet to be established. This review explores the efficacy of intra-articular interventions, particularly hyaluronic acid (HA), mesenchymal stem cells (MSCs), and platelet-rich plasma (PRP), in the context of OA management. HA injections, with diverse formulations like Hylan G-F20, sodium hyaluronate, and hyaluronan, present varying outcomes, necessitating a nuanced understanding of their effectiveness and timing. MSC therapy, derived from adipose tissue, umbilical cord, or bone marrow, shows promising results in clinical improvement, with adipose-derived MSCs demonstrating efficacy in maintaining benefits over 6 mo. Conversely, bone-marrow-derived MSCs show limited effectiveness, highlighting the need for source-specific considerations. PRP has emerged as a superior option for long-term pain reduction and quality of life improvement, with leukocyte-poor formulations and a critical platelet count of 10 billion demonstrating optimal results. This comprehensive analysis underscores the potential of intra-articular interventions in OA management, emphasizing the need for personalized and evidence-based approaches to enhance treatment efficacy and patient outcomes.
Core tip: Osteoarthritis significantly affects patients by causing pain, functional decline, and reduced quality of life. Traditional treatments mainly manage symptoms, with no disease-modifying interventions established. This review examines intra-articular treatments, including hyaluronic acid (HA), mesenchymal stem cells (MSCs), and platelet-rich plasma (PRP). HA injections show varied outcomes, requiring detailed understanding. MSCs, especially adipose-derived MSCs, demonstrate sustained benefits over 6 mo, while bone-marrow-derived MSCs are less effective. PRP is effective for long-term pain relief and quality of life improvement. Personalized, evidence-based approaches are crucial to enhance treatment efficacy and patient outcomes.
