Amniotic suspension allograft may be an effective nonoperative treatment of symptomatic knee osteoarthritis, according to recently published results.
“The take-home message would be that amniotic suspension allograft (amniotic fluid plus membrane) is a treatment option for knee osteoarthritis,” Andreas H. Gomoll, MD, told Healio.com/Orthopedics. “This was the first study specifically looking into the use of a placental product in a blinded fashion with randomization against hyaluronan and saline injection.”
Researchers identified 200 patients with OA who were randomized to receive either amniotic suspension allograft, hyaluronic acid (HA) or saline. Treatment groups were compared for changes from baseline in patient-reported outcomes, five-level EuroQoL-5D, KOOS, VAS, Tegner and single assessment numerical evaluation scores. Treatment failures included patients reporting unacceptable pain at 3 months. From baseline to 3 and 6 months, changes in patient-reported outcomes were compared to complete statistical analysis.
Results showed that at 3 months, 13.2% of patients who received amniotic suspension allograft reported unacceptable pain compared with 68.8% of patients who received HA and 75% of patients who received saline. Significantly greater improvements from baseline for overall pain, KOOS pain and KOOS activities of daily living scores were seen in patients who received amniotic suspension allograft compared with patients who received HA, according to results at 3 months, and compared with both groups, according to results at 6 months. At 3 and 6 months, patients who received the amniotic suspension allograft compared with patients who received HA and saline had greater improvements in KOOS symptom scores.
Investigators noted Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials responder rates were 69.1% for amniotic suspension allograft, 39.1% for HA and 42.6% for saline. Greater improvements in patient-reported outcomes were seen in patients who received amniotic suspension allograft. These patients also had fewer patient-reported unacceptable pain compared with patients who received HA and saline.
Gomoll said, “There will be an extension study reporting outcomes up to a year, as well as results of [amniotic suspension allograft] ASA injection after failed prior treatment with other injections.” – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.