Amniotic Fluid Injections to Treat Painful Knees

Orthopedics This Week reports on the results of an HSS trial published in the Journal of Knee Surgery, which found amniotic suspension allograft (ASA) injections may be a superior anti-inflammatory treatment for knee osteoarthritis.

The multicenter, three arm, randomized to a control trial compared the ability of ASA to modulate inflammation and swelling as compared to saline and hyaluronic acid (HA) injections. Primary endpoints included changes from baseline of patient-reported outcomes (PROs)-EQ-5D-5L, Knee Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), Tegner, and Single Assessment Numerical Evaluation (SANE). Patients who received ASA demonstrated greater improvements in overall pain (VAS), KOOS pain, and KOOS-activities of daily living scores compared to those in the HA group at six months and in both groups at six months.

Andreas H. Gomoll, MD, sports medicine surgeon at HSS, commented on the findings stating, “The amniotic fluid and membrane injection showed the best results because there are a lot of anti-inflammatory substances in amniotic membrane and it is the inflammation and swelling that really hurts.” Dr. Gomoll explained, “We use a lot of injections with injured athletes. If there is a truly mechanical problem, then surgery is indicated, but many athletes just have pain and inflammation. Less is often more when it comes to treating these athletes because it is harder to get back to sport after surgery.” Furthermore he added, “The amniotic suspension allograft injections are also a good option for older patients as well. They allow us to try to delay or prevent all together the need for knee replacement.”

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