Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report
Abstract Background At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative managemen...
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doaj-296ba0e276154b13bf2cc66e84a4228b2020-11-24T21:47:09ZengBMCBMC Musculoskeletal Disorders1471-24742017-09-011811510.1186/s12891-017-1754-3Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case reportMatthew J. Sampson0Margie Kabbani1Ravi Krishnan2Michael Nganga3Annika Theodoulou4Jeganath Krishnan5Benson RadiologyThe International Musculoskeletal Research Institute IncParadigm BioPharmaceuticals LtdThe International Musculoskeletal Research Institute IncThe International Musculoskeletal Research Institute IncThe International Musculoskeletal Research Institute IncAbstract Background At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative management with Total Knee Arthroplasty (TKA). We report the use of Pentosan Polysulphate Sodium (PPS) for the treatment of BMLs of the knee. Case presentation We report the case of a 70-year-old female with knee osteoarthritis presenting with a high level of knee pain, scoring 8 on the Numerical Rating Scale (NRS), and functional limitation demonstrating a poor Lysholm Knee Score of 37. MRI scans of the knee revealed subchondral BML in the medial femoral condyle and medial tibial plateau. The patient was administered a course of Pentosan Polysulphate Sodium (PPS) intramuscularly twice weekly, for 3 weeks. MRI scans 2 weeks post-treatment showed complete resolution of the bone marrow edema at the medial femoral condyle and medial tibial plateau with concomitant recovery from pain (NRS pain score of 0), and a 43% improvement of the Lysholm Knee Score. In addition, marked reduction in joint effusion was also demonstrated in the MRI scan post PPS therapy. Conclusion The MRI interpretations demonstrate improved clinical outcome measures ensuing therapeutic intervention with PPS, and warranting further investigation into the efficacy of PPS in the treatment of BML associated pain and dysfunction in the osteoarthritic population via randomized controlled trial, or equivalent rigorous methodological technique.http://link.springer.com/article/10.1186/s12891-017-1754-3Bone marrow edema lesionMRIKnee osteoarthritisJoint effusion; Pentosan polysulphate sodium |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Matthew J. Sampson Margie Kabbani Ravi Krishnan Michael Nganga Annika Theodoulou Jeganath Krishnan |
spellingShingle |
Matthew J. Sampson Margie Kabbani Ravi Krishnan Michael Nganga Annika Theodoulou Jeganath Krishnan Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report BMC Musculoskeletal Disorders Bone marrow edema lesion MRI Knee osteoarthritis Joint effusion; Pentosan polysulphate sodium |
author_facet |
Matthew J. Sampson Margie Kabbani Ravi Krishnan Michael Nganga Annika Theodoulou Jeganath Krishnan |
author_sort |
Matthew J. Sampson |
title |
Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report |
title_short |
Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report |
title_full |
Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report |
title_fullStr |
Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report |
title_full_unstemmed |
Improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral Bone Marrow Edema Lesion and joint effusion in an osteoarthritic patient following Pentosan Polysulphate Sodium treatment: a case report |
title_sort |
improved clinical outcome measures of knee pain and function with concurrent resolution of subchondral bone marrow edema lesion and joint effusion in an osteoarthritic patient following pentosan polysulphate sodium treatment: a case report |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2017-09-01 |
description |
Abstract Background At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative management with Total Knee Arthroplasty (TKA). We report the use of Pentosan Polysulphate Sodium (PPS) for the treatment of BMLs of the knee. Case presentation We report the case of a 70-year-old female with knee osteoarthritis presenting with a high level of knee pain, scoring 8 on the Numerical Rating Scale (NRS), and functional limitation demonstrating a poor Lysholm Knee Score of 37. MRI scans of the knee revealed subchondral BML in the medial femoral condyle and medial tibial plateau. The patient was administered a course of Pentosan Polysulphate Sodium (PPS) intramuscularly twice weekly, for 3 weeks. MRI scans 2 weeks post-treatment showed complete resolution of the bone marrow edema at the medial femoral condyle and medial tibial plateau with concomitant recovery from pain (NRS pain score of 0), and a 43% improvement of the Lysholm Knee Score. In addition, marked reduction in joint effusion was also demonstrated in the MRI scan post PPS therapy. Conclusion The MRI interpretations demonstrate improved clinical outcome measures ensuing therapeutic intervention with PPS, and warranting further investigation into the efficacy of PPS in the treatment of BML associated pain and dysfunction in the osteoarthritic population via randomized controlled trial, or equivalent rigorous methodological technique. |
topic |
Bone marrow edema lesion MRI Knee osteoarthritis Joint effusion; Pentosan polysulphate sodium |
url |
http://link.springer.com/article/10.1186/s12891-017-1754-3 |
work_keys_str_mv |
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