What

#ffffff;" />310 patients were still reporting improvements with
The most common form of arthritis, osteoarthritis,respect to pain and joint function. The other 122
remains a therapeutic challenge.patients pursued other treatments such as surgery,
This is a generally felt to be a disease of cartilage.injections, medication or acupuncture.
However, osteoarthritis is a complex disease thatThe number of patients requiring further treatment
appears to involve a complex series of pathwayswas least in the orthokine group. Two years after
that include degradation of cartilage, inflammation oftreatment, improvement was still measurable in all
the lining of the joint (synovium), and stimulation ofthree groups. A clear difference was seen, however,
pain pathways through different chemical messengerin scores on the WOMAC, a questionnaire that is
systems.used in osteoarthritis clinical trials to measure joint
While traditional methods including patient education,function and quality of life.
rest, exercise, anti-inflammatory drugs, injections, andThe orthokine treated patients scored 58 on the
physical therapy offer temporizing measures, there istwo-year follow-up WOMAC, while the hyaluronic acid
still the need for a better solution.and placebo groups scored higher at 88 and 84
The goals for managing osteoarthritis of the hip andrespectively. Another measure called the visual analog
knee are to reduce pain and restore or maintainscale (VAS) that measures pain from 0 (no pain) to
function.100 (most intense pain imaginable), was also used.
A third and even more daunting task is to regenerateThe average pain level prior to treatment was 70 in
new cartilage. There are exciting new developmentsall groups. Two years after treatment, the VAS
in this area.score of the orthokine group was 30 compared with
The results of a two-year study of osteoarthritis of39 in the hyaluronic acid group and 37 in the placebo
the knee assessing the safety and efficacy ofgroup.
orthokine therapy was published in the July-AugustWhat is interesting about this study is how well
2008 issue of "Osteoarthritis and Cartilage".placebo did compared with both hyaluronic acid as
Orthokine is a substance derived from a patient'swell as orthokine in relieving pain. Experienced clinicians
own blood. Orthokine apparently has significanthave known for decades that there is a significant
anti-inflammatory effects. This material is thenplacebo effect in just using a needle when it comes
injected into the osteoarthritic joint.to subjective measures such as pain relief.
Researchers at Heinrich Heine University inHowever, the important issue is whether orthokine or
Düsseldorf conducted a two-year studyany other treatment for that matter actually leads to
comparing the effects of injections of orthokine,cartilage regrowth.
hyaluronic acid (a standard lubricant used to treatMuch interest has been generated recently on the
osteoarthritis), and placebo in 310 arthritis patients.use of autologous (meaning the patient’s
The GOAT study (German Osteoarthritis Trial) was aown) therapies in managing osteoarthritis as well as
randomized, placebo-controlled trial, that included 376other degenerative conditions. This therapy is very
men and women with an average age of 58. Thesimilar to the use of platelet rich plasma, which is
primary entrance criterion was chronic knee paincurrently being used to treat tendon problems.
related to osteoarthritis of the knee. ParticipantsPlatelet rich plasma is derived from the
were randomly assigned to one of three treatmentpatient’s whole blood using a special
groups that received injections of orthokine,centrifugation technique.
hyaluronic acid or saline (placebo). Treatments wereFor osteoarthritis, we have found that combining
administered as six sessions over three weeks.autologous stem cells – obtained from bone
Patients were evaluated at six weeks, three months,marrow aspirated from the pelvic bone of the patient
six months (double blinded) and then 24 monthsusing local anesthetic- and platelet rich plasma appears
(single blinded). Two years later, 310 participantsto be an effective treatment for the knee and hip.
agreed to take part in a follow-up examination.Both the stem cells as well as the platelet rich plasma
After two years, patients treated with orthokineare injected into the osteoarthritic joint. This
scored significantly better than those treated withcombination treatment not only aids in pain relief but
hyaluronic acid or placebo on measures of pain andthere also appears to be stimulation of cartilage
joint function.regeneration.
The results after two years showed that 188 of the