ObjectiveTo investigate the safety and efficacy of human umbilical cord mesenchymal stem cells (MSCs) by intra-articular injection for degenerative knee osteoarthritis.
MethodsBetween January 2015 and January 2016, 36 patients with moderate or severe degenerative knee osteoarthritis were randomly devided into 2 groups (n=18). Intra-articular injection of 2.5-3.0 mL human umbilical cord MSCs suspension containing (2-3)×107 cells was performed once a month for 2 times as a course of treatment in the cell treatment group; sodium hyaluronate by intra-articular injection was used once a week for 5 times as a course of treatment in the control group. There was no significant difference in gender, age, body mass index, side, stage of osteoarthritis, course of disease, and preoperative Lysholm score of the knee joint, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and SF-36 scale score between 2 groups (P > 0.05). The clinical efficacy was evaluated by SF-36 scale score, Lysholm score, and WOMAC score.
ResultsAll patients of 2 groups received a course of treatment. The patients were followed up for 6 months. After injection, the incidences of pain and swelling in the cell treatment group were significantly higher than those in the control group (χ2=16.200, P=0.000; χ2=11.688, P=0.000), but no significant difference was found in the incidence of effusion (χ2=2.118, P=0.146). In the cell treatment group, Lysholm score at 1-6 months after treatment, WOMAC score and SF-36 scale score at 2-6 months after treatment were significantly better when compared with scores before treatment (P < 0.05), and no recurrence of knee pain was observed during follow-up. In the control group, there was no significant difference in Lysholm score and SF-36 scale score between pre-and post-treatment (P > 0.05); there were significant differences in WOMAC score between pre-treatment and at 1, 2, 3 months after treatment (P < 0.05); at 3 months after treatment, 11 patients had joint pain symptoms again. No significant difference was found in the knee joint function score and SF-36 scale score at 1 and 2 months after treatment between 2 groups (P > 0.05), but the scores of the cell treatment group were significantly better than those of the control group at 3 and 6 months (P < 0.05).
ConclusionIt can significantly improve the joint function and quality of life to use intra-articular injection of human umbilical cord MSCs for treating degenerative knee osteoarthritis. It takes effect after 1 month and the treatment effect can be sustained for 6 months.
Objective To investigate the effect of ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilatation in the treatment of frozen shoulder in different clinical stage. Methods The clinical data of patients with frozen shoulder diagnosed in Zigong Fourth People’s Hospital from January 2020 to January 2021 were collected retrospectively. The patients were divided into three groups according to the clinical stage of frozen shoulder (stage Ⅰ, stage Ⅱ and stage Ⅲ). All patients volunteered to receive ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilatation for 3 consecutive times, with a 2-week interval for each treatment, and followed up for 6 months. Before treatment and 2 weeks, 4 weeks, 2 months, 4 months and 6 months after treatment, the patients were scored with Visual Analog Scale (VAS) and Active Range of Shoulder Motion (AROM), and the capsule thickness of shoulder were measured, respectively. Results A total of 150 patients were included, including 61 patients in stage Ⅰ, 74 patients in stage Ⅱ and 15 patients in stage Ⅲ. The thickness of shoulder joint capsule on the affected side was thicker than that on the healthy side (t=24.384, P<0.001). After treatment, the thickness of shoulder joint capsule and VAS score decreased (P<0.05), and the AROM score increased (P<0.05). Before treatment, the thickness of shoulder joint capsule in stageⅡpatients was higher than that in stageⅠand Ⅲ patients [(4.3±1.0) vs. (2.9±0.5) vs. (3.1±0.4) mm; F=57.195, P<0.001]. Four weeks, 2 months, 4 months and 6 months after treatment, the decrease of shoulder joint capsule thickness was the largest in stageⅡpatients (P<0.05). Compared with stageⅡand Ⅲ patients, stageⅠpatients had the highest VAS score before treatment (7.7±0.7 vs. 5.1±0.8 vs. 4.5±0.7; F=233.560, P<0.001). There was no significant difference in VAS scores among the three groups 4 weeks (F=1.679, P=0.190), 4 months (F=1.348, P=0.263) or 6 months (F= 0.940, P=0.393) after treatment, while there were significant differences in VAS scores among the three groups 2 weeks (F=66.924, P<0.001) and 2 months (F=9.598, P<0.001) after treatment. Compared with stageⅠand Ⅲ patients, stageⅡpatients had the lowest AROM score before treatment (15.2±1.8 vs. 23.5±1.9 vs. 26.1±3.5; F=343.718, P<0.001). Four weeks (F=0.034, P=0.967), 2 months (F=0.222, P=0.801), 4 months (F=0.634, P=0.532) or 6 months (F=0.001, P=0.999) after treatment, there was no significant difference in AROM scores among the three groups, while there was significant difference in AROM scores among the three groups 2 weeks after treatment (F=177.135, P<0.001).Conclusions Ultrasound-guided intra-articular injection of shoulder joint combined with hydraulic dilation has good efficacy in the treatment of frozen shoulder in different clinical stage. Early injection treatment can shorten the course of the disease and relieve the pain of patients during the course of the disease.
Objective To compare effects of intra-articular injection of corticosteroid or viscoelastic agent alone or a combination of the two drugs for treatment of temporomandibular joint disorders. Methods A prospective quasirandomized controlled trial was conducted to compare 3 treatment protocols of intra-articular injections in the upper compartment of the joint immediately following arthrocentesis repeatedly every 10 days: ① triamcinolone 8 mg alone for 3 times, ② 1% hyaluronate 1 ml alone for 4 times, and ③ triamcinolone 8 mg for 2 times then 1% hyaluronate 1 ml for 2 times. Clinical examinations were done at baseline, 1, 12, and 24 months after end of the treatments. According to improvement of the symptoms and clinical signs, the effectiveness was graded in 3 classes: excellent, better, no change, or worse. The first two were classified as effective. Effective rates of the treatments and subgroups were compared statistically. Results Five hundred and sixty four patients with temporomandibular disorders were included and randomly allocated to 3 groups with 188 patients in each group. The rate of lost follow up at 24 months was 6.9% to 10.1%. At one month after treatment, the triamcinolone group had a better effective rate at 92.0%. At 12 and 24 months of follow up, effective rates of the hyaluronate group were better than those in the triamcinolone alone group (84.6% vs. 54.1% and 83.4% vs. 40.4%). Effective rates of combining triamcinolone and hyaluronate group at 12 and 24 months were 90.4% and 66.3% respectively. Conclusion Intra-articular injection of corticosteroid has better results in a short term and hyaluronate has better results in a long term in the treatment of temporomandibular joint disorders.
ObjectiveTo systematically review the effectiveness of different pharmacologic agents administered via ultrasound-guided intra-articular injection for pain relief and functional improvement in early-to-mid stage knee osteoarthritis. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, WanFang Data, SinoMed, ClinicalTrials.gov, and the WHO international clinical trials registry platform were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to May 8, 2025. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The network meta-analysis was then performed by using R 4.4.3 software. ResultsA total of 23 RCTs involving 1 587 participants and nine intervention strategies were included. The results revealed: (1) For pain relief, platelet-rich plasma combined with ultrasound guidance ranked highest; (2) In terms of functional improvement, platelet-rich plasma demonstrated consistent advantages across multiple dimensions of joint function, stiffness, and total score; (3) Hypertonic dextrose and autologous adipose tissue injections showed potential benefits in specific outcome dimensions; (4) Interventions such as traditional blind injections, corticosteroids, and ozone ranked moderately; (5) Safety: Based on limited reports, current evidence indicates that adverse events were predominantly mild and transient local reactions, with no serious events directly attributable to the interventions. ConclusionCurrent evidence shows that platelet-rich plasma under ultrasound guidance demonstrated a consistent advantage across multiple outcome measures, characterized by favorable safety, targeting precision, and clinical applicability.
