Autologous Bone Marrow Aspirate Concentrate Injection for the Treatment of Early Osteoarthritis:Baghdad 2022
Condition: Treatment Complication
MeSH terms: Osteoarthritis
Study type: Interventional

Summary: 
      We present a randomized controlled trial (RCT) to assess the efﬁcacy of autologous bone
      marrow aspirate concentrate BMAC of 1.8x 10 9 median cellular content in the treatment of
      early symptomatic knee OA. We use 2 injections 2 months apart (8).
    

Detailed description: 
      1. To evaluate the efficacy of bone marrow aspirate concentrate (BMAC) therapy on pain,
           function and disease modification in knee osteoarthritis.

        2. To determine the potential of BMAC therapy to achieve disease modification, as detected
           through radiological examination using magnetic resonance imaging (MRI) techniques.

        3. Methodology:

      A randomized controlled trial will be held in Ibn-Sina training hospital in Baghdad. All
      participants will complete written informed consent. The study will be a single centered
      trial.

      The trial design will consist of 60 participant randomly and equally allocated to control and
      treatment group by simple random sampling. Participants will not be blinded to their
      treatment allocation. Control group will receive conventional treatment only. Intervention
      group will receive (2 injections) intra-articular injections of (4cc) per joint at (8 weeks'
      interval).

      Intervention:

      50 cc bone marrow aspirates concentrate after centrifugation with final volume up to 7 cc.

      Assess total nucleated count and viability. Bone marrow aspirate concentrate is chosen as a
      source of mesenchymal stem cells, because of safe and easy procedure.

      Bone marrow aspiration is done under local or general anesthesia, depending on the individual
      case. Around 50 cc of bone marrow is aspirated from the posterior iliac crest after proper
      sterilization using bone marrow aspiration needle (size according to the patient) and
      collected in heparinized syringes. Mononuclear cells (MNCs) are obtained by centrifugation.
      The isolated MNCs are checked for viability manually and confirmed on automated cell count
      machine.

      The separated MNCs is administered intra-articularly immediately after centrifugation.

      Place:

      Bone marrow aspiration and centrifugation procedure is done in clean area, in operation room
      HEPA filtered with all instruments included. Cell count viability and flow cytometry can be
      sent to nearby lab.CD markers (90, 44,29,105,34).

      Instruments:

      Bone marrow aspiration kit, centrifuge, automated cell counter.

      Sample size and sampling technique:

      The conventional treatment is usually classic treatment .

      Statistical analysis:

      Raw data will be summarized, and presented in appropriate table. The statistical analysis
      will be carried out using SPSS (statistical package for social science) software version 25
    

Intervention name(s): autologous bone marrow aspirate concentrate by centrifugation
Intervention type(s): Procedure
Intervention description(s): 50 cc bone marrow aspirates concentrate after centrifugation with final volume up to 7 cc.
Assess total nucleated count and viability. Bone marrow aspirate concentrate is chosen as a source of mesenchymal stem cells, because of safe and easy procedure.
Bone marrow aspiration is done under local or general anesthesia, depending on the individual case. Around 50 cc of bone marrow is aspirated from the posterior iliac crest after proper sterilization using bone marrow aspiration needle (size according to the patient) and collected in heparinized syringes. Mononuclear cells (MNCs) are obtained by centrifugation. The isolated MNCs are checked for viability manually and confirmed on automated cell count machine.
The separated MNCs is administered intra-articularly immediately after centrifugation.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: double blind
Masking: Single (Participant)
Primary purpose: Treatment