2022, Vol. 26 ›› Issue (18): 2938-2944

Action and mechanism of autologous bone marrow aspiration concentrate in the treatment of knee osteoarthritis

Zhao Jirong1, Yang Tao2, Xu Jiancheng1, Zhao Ning1, Xue Xu1, Ma Tong1   

Abstract: BACKGROUND: At present, although there are many clinical methods for the treatment of knee osteoarthritis, unfortunately, the clinical benefits of traditional treatment methods are limited. In recent years, there are many studies on intra-articular injection of autologous bone marrow aspiration concentrate in the treatment of knee osteoarthritis.   
OBJECTIVE: To review effect and mechanism of autologous bone marrow aspiration concentrate in the treatment of knee osteoarthritis.
METHODS:   Using “bone marrow aspiration concentrate, knee osteoarthritis, bone marrow mesenchymal stem cells, transforming growth factor β, platelet derived growth factor” as Chinese search terms, relevant articles were searched in the databases of CNKI, Wanfang, and VIP. Using “bone marrow aspirate concentrate, BMAC, knee osteoarthritis, KOA, bone marrow mesenchymal stem cells, BMSCs, transforming growth factor β, TGF-β, platelet derived growth factor, PDGF” as English search terms, relevant articles were searched in PubMed and Web of Science databases. The retrieval time was from database establishment to August 2021. According to the inclusion and exclusion criteria, 60 articles were finally included for review.   
RESULTS AND CONCLUSION: (1) Various components in the autologous bone marrow aspiration concentrate can play an important role in the treatment of knee osteoarthritis, which is mainly reflected in the differentiation of bone marrow mesenchymal stem cells into chondrocytes. Transforming growth factor β promotes the proliferation of chondrocytes, and platelet-derived growth factors can regulate the migration, differentiation, and mineralization of mesenchymal stem cells. Insulin-like growth factor 1, fibroblast growth factor 18, and bone morphogenetic protein can protect and repair articular cartilage. (2) Many studies have confirmed that intra-articular injection of bone marrow aspiration concentrate can not only alleviate the pain of patients with knee osteoarthritis, improve mobility, and reduce their dependence on painkillers, but also promote the regeneration of articular cartilage. (3) Bone marrow aspiration concentrate comes from autologous, has no immune rejection, is easy to make, and has low cost. It is an effective way to treat early knee osteoarthritis. Nevertheless, the mechanism of bone marrow aspiration concentrate in the treatment of knee osteoarthritis is still unclear and needs further research and exploration.
Key words: bone marrow aspiration concentrate, knee osteoarthritis, bone marrow mesenchymal stem cells, transforming growth factor β, platelet derived growth factor, tissue engineering, biomedicine, action mechanism