Short-Term Efficacy of Using a Novel Low-Volume Bone Marrow Aspiration Technique to Treat Knee Osteoarthritis: A Retrospective Cohort Study
Bibliographic record
Abstract
Background. Intra-articular bone marrow concentrate (BMC) and aspirate (BMA) injections have been used with mixed results to treat osteoarthritis (OA). Given the various aspiration and concentration methods available for preparing bone marrow, more data are needed to identify the optimal bone marrow harvesting techniques to treat OA. Methods. This retrospective cohort study examined the effect of using low-volume BMAs harvested using the Marrow Cellution™ (MC) device on 160 patients (262 knees) suffering from pain due to knee OA, KL grades 2-4, that did not respond to conservative treatment. Changes in visual analog scores (VAS) for overall daily activity were examined over a six-month time frame in these patients ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mn>63.5</a:mn> <a:mo>±</a:mo> <a:mn>0.97</a:mn> </a:math> years of age; 48.1% male). In addition, changes in the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Patient Global Impression of Change (PGIC scores) were examined over the same time frame in a smaller subset of patients (95 patients including 172 knees). Results. There was a statistically significant improvement in VAS scores for overall daily activity 6 months postprocedure in the study population, <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mn>7.29</c:mn> <c:mo>±</c:mo> <c:mn>0.27</c:mn> </c:math> vs. <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mn>3.76</e:mn> <e:mo>±</e:mo> <e:mn>0.34</e:mn> </e:math> ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>p</g:mi> <g:mo><</g:mo> <g:mn>0.0001</g:mn> </g:math> ), as well as statistically significant improvements in WOMAC scores, <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mn>49.3</i:mn> <i:mo>±</i:mo> <i:mn>4.27</i:mn> </i:math> vs. <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mn>66.3</k:mn> <k:mo>±</k:mo> <k:mn>4.08</k:mn> </k:math> ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>p</m:mi> <m:mo><</m:mo> <m:mn>0.0001</m:mn> </m:math> ). On the individual level, 71% of the cases displayed VAS improvements and 61% of the cases displayed WOMAC improvements that exceeded levels previous studies determined to be the minimal clinically important difference (MCID) for knee OA treatments. The improvements in WOMAC scores were also seen in both the WOMAC pain subscore, <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mn>52.2</o:mn> <o:mo>±</o:mo> <o:mn>4.39</o:mn> </o:math> vs. <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mn>72.2</q:mn> <q:mo>±</q:mo> <q:mn>4.36</q:mn> </q:math> ( <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mi>p</s:mi> <s:mo><</s:mo> <s:mn>0.0001</s:mn> </s:math> ) and the WOMAC function subscore, <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mn>51.6</u:mn> <u:mo>±</u:mo> <u:mn>4.67</u:mn> </u:math> vs. <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M12"> <w:mn>69.0</w:mn> <w:mo>±</w:mo> <w:mn>4.36</w:mn> </w:math> ( <y:math xmlns:y="http://www.w3.org/1998/Math/MathML" id="M13"> <y:mi>p</y:mi> <y:mo><</y:mo> <y:mn>0.0001</y:mn> </y:math> ). In addition, the PGIC scores measuring patient satisfaction improved from <ab:math xmlns:ab="http://www.w3.org/1998/Math/MathML" id="M14"> <ab:mn>4.03</ab:mn> <ab:mo>±</ab:mo> <ab:mn>0.26</ab:mn> </ab:math> at 6 weeks postprocedure to <cb:math xmlns:cb="http://www.w3.org/1998/Math/MathML" id="M15"> <cb:mn>4.65</cb:mn> <cb:mo>±</cb:mo> <cb:mn>0.28</cb:mn> </cb:math> at 6 months postprocedure ( <eb:math xmlns:eb="http://www.w3.org/1998/Math/MathML" id="M16"> <eb:mi>p</eb:mi> <eb:mo><</eb:mo> <eb:mn>0.0001</eb:mn> </eb:math> ). Conclusions. Knee OA patients treated with MC BMA intra-articular injections exhibited significant reductions in VAS pain scores and significant improvements in WOMAC scores that exceeded the minimal clinically important difference thresholds. In addition, reductions in VAS pain scores and improvements in WOMAC scores correlated with higher PGIC scores.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".