{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:32:30Z","timestamp":1791433950173,"version":"4.3.3"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T00:00:00Z","timestamp":1667433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to evaluate the clinical and imaging findings up to 24\u00a0months of follow\u2010up in patients treated with combined subchondral and intra\u2010articular bone marrow aspirate concentrate (BMAC) injections for the treatment of knee osteoarthritis (OA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty consecutive patients (19\u00a0males, 11 females) aged between 40 and 75 years (mean age 56.4\u2009\u00b1\u20098.1 years) with unilateral symptomatic knee OA (Kellgren\u2013Lawrence 2\u20133) were included in the study. Patients were treated with combined intra\u2010articular and subchondral bone BMAC injections (total 9\u00a0ml) under fluoroscopic control. IKDC subjective score, VAS for pain, KOOS, and EQ\u2010VAS were prospectively evaluated up to 24\u00a0months. Radiographs were performed at baseline and at 24\u00a0months after the procedure. MRI was evaluated with the WORMS score at baseline, 6\u201312\u00a0months, and 24\u00a0months of follow\u2010up. The statistical analysis was performed using SPSS v.19.0 and for all tests <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No major complications and a 13% failure rate were reported. The IKDC subjective score remained stable from 62.6\u2009\u00b1\u200919.4 at 12\u00a0months to 63.4\u2009\u00b1\u200917.1 at 24\u00a0months (both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005 compared to baseline, 40.5\u2009\u00b1\u200912.5). Similar improvements were reported for all KOOS subscales, while EQ\u2010VAS did not report any significant improvement. VAS pain worsened from 3.0\u2009\u00b1\u20091.9 at 12\u00a0months to 4.4\u2009\u00b1\u20091.8 at the final follow\u2010up (<jats:italic>p<\/jats:italic>\u2009=\u20090.0001), although remaining lower compared to the baseline value of 6.3\u2009\u00b1\u20091.8 (<jats:italic>p<\/jats:italic>\u2009=\u20090.002). The radiographic evaluation did not reveal signs of improvement or deterioration of the OA grade. The MRI findings showed a worsening in marginal osteophytes and synovitis, but a significant reduction of bone marrow edema at 24\u00a0months (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combined intra\u2010articular and subchondral BMAC injections provided clinical and imaging benefits up to 24\u00a0months for the treatment of symptomatic knee OA, with durable clinical results, a low failure rate, and a significant reduction of bone marrow edema.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07195-w","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T04:03:13Z","timestamp":1667448193000},"page":"2511-2517","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Combined subchondral and intra\u2010articular injections of bone marrow aspirate concentrate provide stable results up to 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June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"EK reports consulting for Cartiheal ldt, Green Bone, Geistlich, and Bioveex, and speaking for Zimmer Biomet and Fidia Farmaceutici SPA. SZ reports non-financial support from personal fees from I\u2009+\u2009SRL, grants from Fidia Farmaceutici SPA, Cartiheal ltd, IGEA clinical biophysics, BIOMET, and Kensey Nash, outside the submitted work.The funders had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results. The other authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval was obtained by the Hospital Ethics Committee of IRCCS Istituto Ortopedico Rizzoli (prot. gen. n. 0013097).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Participation was voluntary and informed consent was obtained from each patient.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}