Synergistically combines the complementary clinical effects of A-PRP and HA to provide added benefit for OA patients. 2
A-PRP: the patient’s platelet concentrate prepared with CellularMatrix, provides an autologous resevoir of growth factors from the patient’s blood.
Platelets are key factors in hard and soft tissue repair mechanisms 1. They provide essential growth factors, such as FGF, PDGF, TGF-ß, EGF, VEGF, IGF, which are involved in stem cell migration, differentiation and proliferation. Additionally, platelets also stimulate fibroblasts and endothelial cells to induce new extracellular matrix deposition and neo-vascularisation respectively.
Plasma contains many factors essential for cell survival including nutrients, vitamins, hormones, electrolytes, growth factors (such as IGF and HGF), and proteins. Among the plasma proteins, the molecules vital for the coagulation process and for the fibrin polymer formation will serve as a scaffold for cell migration and new tissue generation.
Hyaluronic Acid (HA) is a major component of synovial fluid contributing to joint homeostasis.
Product
Immediate formation, in one easy step, of a cell-friendly HA network in which platelets are dispersed, using a system which is specifically approved for preparation of the HA / A-PRP association.
CellularMatrix is a Medical Device that contains 2 ml of natural, non crosslinked, HA at a concentration of 20 mg /ml (40 mg total). The thixotropic cell-separation gel and the sodium citrate anticoagulant solution.
CellularMatrix A-CP-HA - Medical Device Class III - CE2797
Intended Use : Device used to prepare intra-articular injections into the knee for symptomatic treatment of articular pain and mobility improvement.
Evidence
The study involved 100 symptomatic patients with knee cartilage degenerative lesions (Kellgren Lawrence scale grade 0 to III). Fifty patients, who had previously unsatisfactory clinical response to HA alone, were treated with IA injections of autologous CM-PRP-HA combination that was repeated 3 times with 3-week interval, while the other 50 patients were treated with IA HA injections. 3
Both A-PRP and HA have been extensively used to improve lubrication, modulate inflammation and modify the joint catabolic micro-environment, aiming not only for reducing clinical symptoms, but also interfere with OA progression. 3
CellularMatrix offers several advantages in the treatment of OA: HA creates a bioactive scaffolding through which the platelets progressively release their GFs to the target site. A-PRP does not negatively affect the mechanical, elastic or viscous properties of HA. 2
Study
A French multicentre, prospective study, in patients with knee joint OA, shows that 3 injections of 2ml of A-PRP + 2ml of non-cross‐linked HA (CellularMatrix) represent a new medical alternative to knee surgery after failure of HA alone.4
Number of patients: 71 4
Results 4
CellularMatrix provided significant pain relief and functional improvement in 87.3% of patients who had an unsatisfactory clinical response to previous therapy with HA alone. 4
References
- Marx RE.Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg 2004;62:489-96.
- Abate M, Verna S, Schiavone C, Di Gregorio P, Salini V. Efficacy and safety profile of a compound composed of platelet-rich plasma and hyaluronic acid in the treatment for knee osteoarthritis (preliminary results). European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2015;25:1321-6.
- Seleem, N.A., et al., Intra-Articular Injections of Platelet-rich plasma Combined with Hyaluronic Acid Versus Hyaluronic Acid Alone in Treatment of Knee Osteoarthritis. ejpmr, 201. 4(4): p. 608-615.
- Renevier JL, Marc JF. Etude Pilote d’un dispositif médical intra-articulaire innovant dans la prise en charge de la gonarthrose symptomatique fémoro-tibiale grade II-III radiologique après échec d’un AH. Revue du Rhumatisme 2014;81:A202.
- Chen CPC et al. The influence of platelet-rich plasma on synovial fluid volumes, protein concentration, and severity of pain in patients with knee osteoarthritis. Exp Gerontol 2017; 93: 68-72.
- Chen WH et al. Synergistic anabolic of hyaluronic acid and platelet-rich plasma on cartilage regeneration in osteoarthritis therapy. Biomaterials 2014; 35(36): 9599-95607.
- Russo F et al. Platelet-rich plasma and hyaluronic acid blend for the treatment of osteoarthritis: rheological and biological evaluation. PLoS One 2016; 11(6): e0157048.