Amniotic Derived Exosomes with Platelet Rich Fibrin Combined in the Treatment of Hip and Knee Osteoarthritis: A Retrospective 1-Year Follow- Up Study

Author(s): Torbjörn Ogéus DC, PgD, MSc, ScA

Introduction: Osteoarthritis (OA) is a chronic degenerative joint disease characterized by the progressive breakdown of articular cartilage, subchondral bone changes, and synovial inflammation. Recent advances in regenerative medicine have focused on exosome-based therapies as a promising approach to address this challenge. Exosomes, small extracellular vesicles derived from various cell types, play crucial roles in intercellular communication, modulate inflammatory responses, promote chondrocyte proliferation, and enhance extracellular matrix synthesis. Exosomes derived from amniotic fluid have shown promise in regenerative medicine and tissue repair in preclinical studies and early case reports.

Methods: This is a retrospective database cohort study. The clinic database was searched for patients that had undergone exosome treatment combined with PRF for knee and hip OA between August 2023 and February 2024. 114 patients were included in the study. The data analyzed were 1-year follow-up WOMAC scores and sonographic pictures of the femoral joint cartilage in knees before- and 6 months after the treatment.

Results: Statistically significant positive changes in WOMAC scores (p = 0,0001) were presented. Significant sonographic changes to femoral joint cartilage were presented; a mean increase of 1,21 mm (p = 0,0001).

Conclusion: Amniotic derived exosomes combined with PRF is an effective treatment for hip and knee osteoarthritis. Significantly lowered WOMAC scores 1 year after the treatment, combined with a significant positive sonographic change in the femoral cartilage were presented.

Clinical relevance: This is the first human study using exosomes for the treatment of knee and hip OA with results demonstrating positive sonographic structural changes and improved clinical parameters.