Long-Term Effectiveness of Polymerized-Type I Collagen Intra-Articular Injections in Patients with Symptomatic Knee Osteoarthritis: Clinical and Radiographic Evaluation in a Cohort Study
Journal
Advances in Orthopedics
ISSN
2090-3464
2090-3472
Date Issued
2020
Author(s)
Borja-Flores, Adrián
Macías-Hernández, Salvador I.
Hernández-Molina, Gabriela
Reyes-Martínez, Eloy
Belzazar-Castillo de la Torre, José
Ávila-Jiménez, Laura
Vázquez-Bello, María Cristina
León-Mazón, Marco Antonio
Mayo Maldonado, Jonathan
Furuzawa-Carballeda, Janette
Romero-Hernández, Fernanda
Albavera-Hernández, Cidronio
Pérez-Correa, Jesús
Castro-Rocha, Hilda A.
Type
Resource Types::text::journal::journal article
Abstract
Objective. Polymerized-type I collagen (polymerized-collagen) is a downregulator of inflammation and a tissue regenerator. The aim was to evaluate the effect of intra-articular injections (IAIs) of polymerized-collagen among patients with symptomatic knee osteoarthritis (OA) in delaying or preventing joint replacement surgery. Patients and Methods. This was a cohort study of 309 patients with knee OA. Patients with mild-to-moderate disease were treated weekly with IAIs of 2 mL of polymerized-collagen for six weeks (n = 309). Follow-up was for 6-60 months. The primary endpoints included the following determinations: (1) therapeutic effect; (2) survival from total knee replacement surgery (TKR); (3) Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and pain (visual analogue scale, VAS). Clinical improvement was defined as a decrease in pain exceeding 20 mm on the VAS and the achievement of at least 20% improvement from baseline with respect to the WOMAC score. Radiographic analysis was performed at baseline and 60 months. The joint space width in the medial, lateral, and patellofemoral compartments was calculated. Results. Patients who received IAIs of polymerized-collagen had a statistically significant improvement in the primary criteria (p<0.05). Kaplan-Meier survival analysis of the therapeutic effect demonstrated 98.8% survival at 60 months with TKR as the endpoint. There was no significant reduction in joint space in any compartment based on the analyzed radiographs. No serious adverse events were recorded. Conclusion. Polymerized-collagen increased the time to TKR by at least 60 months, modifying the disease course, improving functional disability, and decreasing pain. © 2020 Adrián Borja-Flores et al.