New Injectable Technologies For Knee Pain Highlighted at ICRS

Two new injectable technologies that may potentially fill the gap in treatment options for patients with arthritic joints were highlighted in a session at the 2016 International Cartilage Repair Society (ICRS) in Sorrento, Italy.  While injectable technologies such as hyaluronic acid, PRP, and BMAC have been on the market for some time, studies presented at ICRS found that while these treatments may be efficacious in some patients, results are often temporary and it is difficult to predict which patients will respond to treatment. In an interview with BioMedGPS at the 2016 ICRS, Elizaveta Kon, MD, who has performed extensive research in this arena, speculated that injectable treatments will never turn a bad joint into a good one but may relieve pain for an undetermined period of time and this is why there is such popularity with PRP and stem cell injections. While there were several presentations on the role of injectable therapies at ICRS, one technology that stands out is Zimmer Biomet’s nStride Autologous Protein Solution, a next generation injectable autologous therapy for mild-to-moderate knee OA. Results from a pilot study showed statistically significant improvement over a saline control at one year even though the study was not powered to show significance. The product is CE marked and recently received approval to begin a Phase III IDE trial in the US.

Recognized as a rich source for mesenchymal stem cells, adipose tissue is also being injected into ostearthritic joints as a treatment for knee pain. Preliminary results from two series were presented at Lipogems’ industry symposium, including a study on 24 patients with symptomatic knee pain receiving injections of lipoaspirate, prepared using Lipogems’ system, showed improvement in VAS scores at six months. Interestingly, the study results found that intra-articular injection of microfragmented adipose tissue in older patients had more improved results than younger patients, possibly owing to the quality of the adipose tissue and patient expectation level. Another study evaluating two year results on 20 patients with knee OA receiving one intra-articular injection of lipoaspirate showed a significant reduction in pain and a 21.8 point improvement in KOOS scores. Besides relieving pain, intra-articular injections of microfragmented adipose tissue showed regenerative effects in a 60 year old post-meniscectomy patient, possibly owing to the high presence of mesenchymal stem cells in the lipoaspirate, raising the exciting possibility that injections of lipoaspirate may, in fact, do more than relieve pain in some patients.