Aartsen, V.E. (Vivian) (2017) Intra-articular injections of Orthokine reduce symptoms of painand disability in patients with glenohumeral osteoarthritis. thesis, Medicine.
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Abstract
Introduction. Current non-surgical treatments for glenohumeral osteoarthritis (GH-OA) do not work satisfactorily and tend to focus on reducing pain, not on reducing disability. Autologous conditioned serum (ACS), marketed under the trade name Orthokine, is derived from patients’ own blood and has an anti-inflammatory effect. The primary objective of this study was to determine whether intra-articular injections of Orthokine could reduce symptoms of pain and disability in patients with GH-OA. Secondary objectives included whether the effect of Orthokine was related to the radiological type and degree of GH-OA, and also could it delay the need for a shoulder replacement. Patients and methods. Forty-four shoulders in thirty-nine patients with painful GH-OA were included in a longitudinal study and received a series of intra-articular injections of Orthokine. The radiological type of GH-OA was determined according to the Walch classification. The primary efficacy objective consisted of a significant decrease of the total Shoulder Pain And Disability Index (SPADI) of at least 8% post-treatment. The clinical effect of Orthokine was additionally assessed by measuring the passive and active range of shoulder motion, by statements of patients and by two other questionnaires: the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and the Constant score. Results. A significant decrease of the total SPADI score (mean -14.06%; 95% CI -21.68 to -6.43; p=0.001), as well in both sub scores for pain and disability, was measured after treatment with the Orthokine series. Both active and passive range of motion improved significantly post-treatment. The effect of Orthokine did not differ between the different Walch classifications (centred/decentred) and joint space (yes/no). Post-treatment results were not significantly different in the group who had a shoulder replacement after treatment with Orthokine. In addition, 2/3 of the patients stated that Orthokine delayed their need for a shoulder replacement. Conclusion. Our data show a significant decrease of symptoms of pain and disability after treatment with Orthokine in patients with GH-OA. Neither the radiological type and degree of GH-OA were found to influence the effect of Orthokine. Whether Orthokine could delay the need for a shoulder replacement needs to be determined in future research.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor Drs. and Ploegmakers, Joris |
| Supervisor name: | Supervisors and Coghlan, Dr. Jennifer PhD and Bell, Prof. Simon F.R.C.S. F.R.A.C.S. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1321 |
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