Comparing Bone Marrow Stimulation And Intraarticular Injection Of Hyaluronic Acid Triamcinolone Combination And Bone Marrow Stimulation Alone On Functional Outcome, Cartilage Repair And Serum Interleukin 15 Level On Moderate Stage Knee Osteoarthritis Pati

Abstract

Background:  Knee osteoarthritis (KOA) is the most prevalent musculoskeletal disorder and the leading cause of disability in adults over the age 45 years. Many patient and provider think of arthroplasty as the only surgical option for treatment of KOA advanced stage. However, there are several surgical options for KOA which can be therapeutic alternative. This study aims to compare the effect of bone marrow stimulation (BMS) and intraarticular injection of hyaluronic acid (HA) triamcinolone combination vs BMS alone on functional outcome, cartilage repair and serum interleukin 15 level in moderate stage KOA patients.

Method: This study was conducted on patients who presented to Orthopedic Department Hasri Ainun Habibie Hospital from February 2023 to June 2024. 36 consecutive patients who diagnose as moderate KOA based on Kellgren-Lawrence classification, divided into 2 groups. Observation group underwent BMS and intraarticular injection of HA triamcinolone combination and control group underwent BMS alone. WOMAC score, MRI AMADEUS score, and serum IL-15 level was examined before the procedure and 6 months after the procedure.

Result: study showed that WOMAC score significantly increased on both groups, but the change in observation group was better, especially in pain and stiffness subscale. MRI AMADEUS score significantly increased on observation group. IL-15 serum level significantly decreased on both groups. We found positive significant correlation between IL-15 and functional outcome on observation group.

Conclusion: BMS and intraarticular injection of HA triamcinolone improve functional outcome, cartilage repair and reducing serum IL15 level better than BMS alone in moderate stage KOA patients.