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Journal article

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 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.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12891-017-1754-3

Authors


More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
Primary Care Health Sciences
Department:
Unknown
Role:
Author
ORCID:
0000-0002-8942-2167


Publisher:
BioMed Central
Journal:
BMC Musculoskeletal Disorders More from this journal
Volume:
18
Issue:
1
Pages:
396
Publication date:
2017-09-12
Acceptance date:
2017-09-05
DOI:
EISSN:
1471-2474
ISSN:
1471-2474
Pmid:
28899386


Language:
English
Keywords:
Pubs id:
pubs:935103
UUID:
uuid:a6150a0a-fb8b-49c2-9c29-e75e4d0af747
Local pid:
pubs:935103
Source identifiers:
935103
Deposit date:
2018-11-08

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