Kireçlenme, önemli bir engellilik ve sağlık harcaması nedenidir. UNC çalışmasına göre diz kireçlenmesi riski %46, kalça kireçlenmesi riski %25'tir. Tedavide eğitim, kilo verme, ağrı kesiciler ve PRP/kök hücre enjeksiyonları kullanılıyor. Yağ dokusu enjeksiyonları da umut vaat ediyor.
Discussion Degenerative joint diseases represent a major and growing cause of disability and health care resource consumption. According to the Johnston County Osteoarthritis Project, a long-term study from the University of North Carolina the lifetime risk of developing OA of the knee is approximately 46%, and the lifetime risk of developing OA of the hip is 25%.16 Although the most common cause of osteoarthritis of the knee is age, joint injuries can accelerate chondrocyte senescence, and this acceleration plays a role in the joint degeneration responsible for posttraumatic osteoarthritis.17 All components of the cartilage play different roles in the stabilization and protection of the joint. Alterations in the structure of the articular cartilage lead to injury and joint degeneration.18 Knee OA treatment options include nonpharmacological treatments such as patient education and self-management strategies, advising weight loss and strengthening programs. Oral analgesics and anti-inflammatories are pharmacological options that are commonly used and can be helpful for managing knee OA in the short-term but are less effective for long-term management. Intra-articular injections are also employed to manage knee OA ranging from corticosteroids to hyaluronic acid to more recently PRP and even stem cells while several other injection therapies are presently being studied.9 Autologous platelets are expected to release chondrogenic growth factors following the activation of clotting pathways and several studies support the efficacy of PRP for OA.19–21 Injection of ASCs following arthroscopic debridement or PRP with hyaluronic acid yielded improved clinical outcomes using the WOMAC index, Lysholm, and VAS pain score 3 months postoperatively, along with increased cartilage thickness on magnetic resonance imaging.22 The development of percutaneous interventions that potentially enhance regenerative processes has improved the chances for nonsurgical treatments that produce durable improvement in pain and function.13 Current use of adipose tissue as an injectable includes augmenting tissue volume and correcting contour irregularities, but recent applications promise to capture fat's immunomodulatory and regenerative capacity. Adipose tissue is an important source of mesenchymal stem cells (MSCs). Compared with bone marrow-derived MSCs, ASCs from lipoaspirates can be harvested using a less-invasive procedure and in larger amounts. Moreover, they can commit toward the chondrogenic, osteogenic, adipogenic, myogenic, and neurogenic lineages.23 Our study was conducted using an intra-articular percutaneous injection of processed and decanted subcutaneous fat, a simple and inexpensive procedure, to treat a series of
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Kireçlenme, önemli bir engellilik ve sağlık harcaması nedenidir. UNC çalışmasına göre diz kireçlenmesi riski %46, kalça kireçlenmesi riski %25'tir. Tedavide eğitim, kilo verme, ağrı kesiciler ve PRP/kök hücre enjeksiyonları kullanılıyor. Yağ dokusu enjeksiyonları da umut vaat ediyor.
Discussion Degenerative joint diseases represent a major and growing cause of disability and health care resource consumption. According to the Johnston County Osteoarthritis Project, a long-term study from the University of North Carolina the lifetime risk of developing OA of the knee is approximately 46%, and the lifetime risk of developing OA of the hip is 25%.16 Although the most common cause of osteoarthritis of the knee is age, joint injuries can accelerate chondrocyte senescence, and this acceleration plays a role in the joint degeneration responsible for posttraumatic osteoarthritis.17 All components of the cartilage play different roles in the stabilization and protection of the joint. Alterations in the structure of the articular cartilage lead to injury and joint degeneration.18 Knee OA treatment options include nonpharmacological treatments such as patient education and self-management strategies, advising weight loss and strengthening programs. Oral analgesics and anti-inflammatories are pharmacological options that are commonly used and can be helpful for managing knee OA in the short-term but are less effective for long-term management. Intra-articular injections are also employed to manage knee OA ranging from corticosteroids to hyaluronic acid to more recently PRP and even stem cells while several other injection therapies are presently being studied.9 Autologous platelets are expected to release chondrogenic growth factors following the activation of clotting pathways and several studies support the efficacy of PRP for OA.19–21 Injection of ASCs following arthroscopic debridement or PRP with hyaluronic acid yielded improved clinical outcomes using the WOMAC index, Lysholm, and VAS pain score 3 months postoperatively, along with increased cartilage thickness on magnetic resonance imaging.22 The development of percutaneous interventions that potentially enhance regenerative processes has improved the chances for nonsurgical treatments that produce durable improvement in pain and function.13 Current use of adipose tissue as an injectable includes augmenting tissue volume and correcting contour irregularities, but recent applications promise to capture fat's immunomodulatory and regenerative capacity. Adipose tissue is an important source of mesenchymal stem cells (MSCs). Compared with bone marrow-derived MSCs, ASCs from lipoaspirates can be harvested using a less-invasive procedure and in larger amounts. Moreover, they can commit toward the chondrogenic, osteogenic, adipogenic, myogenic, and neurogenic lineages.23 Our study was conducted using an intra-articular percutaneous injection of processed and decanted subcutaneous fat, a simple and inexpensive procedure, to treat a series of
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