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Safety and Efficacy of Bone-Marrow Aspirate Concentrate in Hip Osteoarthritis: A Systematic Review of Current Clinical Evidence

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Abstract

Introduction

Hip osteoarthritis (OA) is one of the leading causes of disability and morbidity worldwide. It is estimated to affect 9.2% individuals globally with age over 45 years. Conventional treatment modalities have limitations and side-effects. To overcome these limitations, over the last decade, there has been an increased interest in the use of orthobiologics derived from autologous sources including platelet-rich plasma (PRP), bone-marrow aspirate concentrate (BMAC) and adipose tissue derived formulations. This review qualitatively presents the in-vitro, pre-clinical, clinical and on-going clinical studies exploring the safety and efficacy of BMAC for management of hip OA.

Materials and methods

The electronic database search was done through PubMed, Embase, Web of Science, Scopus, ProQuest and Google Scholar till February 2024. The search terms used were “osteoarthritis” OR “hip osteoarthritis” OR “orthobiologics” OR “efficacy or use of orthobiologic treatment” OR “bone-marrow concentrate” OR “bone-marrow aspirate concentrate”, AND “BMAC”. The inclusion criteria were clinical studies of any level of evidence written in the English language, published till February 2024, evaluating the safety and efficacy of intra-articular administration of BMAC for the management of hip OA.

Results

A total of 5 studies were included in this review for qualitative data synthesis. The total number of patients who participated in the study was 182, ranging from 4 to 112 in a single study. No adverse events were reported throughout the duration of the study. In addition, intra-articular administration of BMAC led to reduced pain, and improved function and overall quality of life (QoL).

Conclusion

The results from this review demonstrated that administration of BMAC is safe and potentially efficacious in terms of reducing pain, improving function and overall QoL of patients with hip OA in short- and mid-term average follow-up based on the included studies. Nonetheless, more adequately powered, multi-center, prospective, double-blind, non-randomized and randomized controlled trials with long-term follow-up are warranted to establish long-term safety and efficacy of BMAC for management of hip OA and justify its routine clinical use.

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Authors and Affiliations

  1. Fellow in Orthopaedic Rheumatology, Dr RML National Law University, Lucknow, 226010, Uttar Pradesh, India

    Sushma Chandrashekar

  2. Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, 600077, Tamil Nadu, India

    Madhan Jeyaraman & Naveen Jeyaraman

  3. Indian Stem Cell Study Group (ISCSG) Association, Lucknow, 226010, Uttar Pradesh, India

    Madhan Jeyaraman, Naveen Jeyaraman, Manish Khanna & Ashim Gupta

  4. Department of Orthopaedics, South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX, 78045, USA

    Madhan Jeyaraman & Ashim Gupta

  5. Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India

    Prabu Mounissamy

  6. Department of Orthopaedics, Dr KNS Mayo Institute of Medical Sciences, Lucknow, 225001, Uttar Pradesh, India

    Manish Khanna

  7. Regenerative Orthopaedics, Noida, 201301, Uttar Pradesh, India

    Ashim Gupta

  8. Future Biologics, Lawrenceville, GA, 30043, USA

    Ashim Gupta

  9. BioIntegrate, Lawrenceville, GA, 30043, USA

    Ashim Gupta

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  1. Sushma Chandrashekar
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Correspondence to Naveen Jeyaraman.

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Chandrashekar, S., Jeyaraman, M., Mounissamy, P. et al. Safety and Efficacy of Bone-Marrow Aspirate Concentrate in Hip Osteoarthritis: A Systematic Review of Current Clinical Evidence. JOIO (2024). https://doi.org/10.1007/s43465-024-01183-7

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