Subchondral versus intra-articular orthobiologic injections for the treatment of knee osteoarthritis: a review

• Published in: Regenerative medicine Vol. 17; no. 6; pp. 389 - 400
• Main Authors: Gardner, James E, Williams, Christopher W, Bowers, Robert L
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.06.2022
• Subjects: adipose; Cartilage, Articular; Humans; Injections, Intra-Articular; intra-articular; intraosseous; Mesenchymal Stem Cells; mesenchymal stromal cells; orthobiologics; osteoarthritis; Osteoarthritis, Knee - drug therapy; Platelet-Rich Plasma; subchondral bone marrow concentrate; intraosseous; intra-articular; subchondral bone marrow concentrate; osteoarthritis; mesenchymal stromal cells; orthobiologics; adipose; platelet-rich plasma
• ISSN: 1746-0751; 1746-076X
• DOI: 10.2217/rme-2021-0174

Recent perspectives suggest that osteoarthritis (OA) is a disease involving not only the articular cartilage but also the osteochondral unit, including the synovium, supportive cartilage and subchondral bone. Current conservative treatments for OA are symptomatic and do not prevent progression or reverse the disease process. Compelling data show that intra-articular orthobiologic injections, such as platelet-rich plasma and mesenchymal stromal cells, are effective in providing relief of OA symptoms. However, recent data suggest that injections of orthobiologics into the subchondral bone may be superior to intra-articular injections for the management of OA. This review highlights the rationale and current evidence for intra-articular and subchondral bone injections of orthobiologics for the treatment of OA.