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Intervention comparison between stem cell and hyaluronic acid injection in knee osteoarthritis treatment : a systematic review with a meta-analysis
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Resumo(s)
O tratamento da osteoartrose está limitado ao alívio sintomática e ao atraso da progressão da doença. As opções terapêuticas englobam uma abordagem conservadora, durante os estádios iniciais e uma abordagem cirúrgica nos estádios finais. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis concebeu um esquema terapêutico com três patamares. Foram identificadas duas intervenções farmacológicas capazes de atrasar a substituição protésica da articulação: o sulfato de glucosamina e o ácido hialurónico. O ácido hialurónico consegue atrasar a progressão para osteoartrose, controlar os sintomas e adiar a necessidade de uma prótese. Assim como o ácido hialurónico, os corticosteroides injetáveis, apesar de controlar eficazmente a dor, não conseguem parar o processo patológico da osteoartrose, tornado a intervenção cirúrgica praticamente inevitável. O uso das células estaminais tem ganho preponderância por causa das propriedades terapêuticas que lhes são atribuídas em investigações recentes. Pensa-se que são capazes de reverter a fisiopatologia da OA ao melhorar a estrutura e função da articulação. A comparação da eficácia entre as células estaminais e o ácido hialurónico pode ajudar a descobrir uma terapêutica modificadora do processo patológico da osteoartrose, futuramente evitando recorrer a próteses articulares.
Treatment for Osteoarthritis (OA) is limited to symptom alleviation and slowing of disease progression. Therefore, the treatment options comprise a conservative approach at the initial stages and surgical interventions at the final stages of OA. For the management of OA, the consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis elaborated a stepwise therapeutic scheme with three steps. In this scheme, only two pharmacological interventions were known to have the ability to delay total joint replacement: patented crystalline glucosamine sulfate and Intraarticular hyaluronic acid (IA HA). IA HA can slow disease progression, delay total knee replacement, and control symptoms associated with OA. However, IA HA and corticosteroids injections cannot halt the progression of OA; thus, the surgical intervention becomes inevitable. Stem cell therapy might reverse the mechanisms of OA pathophysiology by improving joint structure and function in OA. Thus, comparing IA HA and Stem Cell therapy effectiveness in Knee OA can help to layout a new therapeutic strategy, potentially leading to the discovery of proper disease-modifying treatment, reducing the need for knee replacement surgery.
Treatment for Osteoarthritis (OA) is limited to symptom alleviation and slowing of disease progression. Therefore, the treatment options comprise a conservative approach at the initial stages and surgical interventions at the final stages of OA. For the management of OA, the consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis elaborated a stepwise therapeutic scheme with three steps. In this scheme, only two pharmacological interventions were known to have the ability to delay total joint replacement: patented crystalline glucosamine sulfate and Intraarticular hyaluronic acid (IA HA). IA HA can slow disease progression, delay total knee replacement, and control symptoms associated with OA. However, IA HA and corticosteroids injections cannot halt the progression of OA; thus, the surgical intervention becomes inevitable. Stem cell therapy might reverse the mechanisms of OA pathophysiology by improving joint structure and function in OA. Thus, comparing IA HA and Stem Cell therapy effectiveness in Knee OA can help to layout a new therapeutic strategy, potentially leading to the discovery of proper disease-modifying treatment, reducing the need for knee replacement surgery.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Osteoartrose do joelho Células estaminais Ácido hialurónico Revisão sistemática Ortopedia