DOS 2018

DOS Kongressen 2018 · 261 Intra-articular metallic gold micro particles relieve pain and enhance function in patients with knee osteoarthritis. A pilot study. Sten Rasmussen, Kristian Kjær Petersen, Lars Arendt-Nielsen Department of Orthopedic Surgery, Aalborg University Hospital; Center for Sensory-Motor Interaction , Aalborg University Background: Animal studies indicate gold ions have a long-acting effect on OA pain. The immuno-modulatory effect of gold ions have for more than 50 years a known anti-inflammatory effect in the treatment of rheumatic arthritis. Gold ions alter the function of macrophages by inhibiting lysosomal enzymes and lowering production of pro-inflammatory cytokines inflammatory cytokines Purpose / Aim of Study: No studies have investigated the effect of intraar- ticular gold micro particle implants for treatment of knee osteoarthritis in hu- mans. The present open, pilot study aimed to investigate if gold ions have a role in treating knee osteoarthritis Materials and Methods: A cohort of 30 patients referred for treatment of knee OA, aged ≥18years, pain ≥ 3 months, synovial effusion on MRI, and Kellgren-Lawrence OA grade 3-4 were included. Metallic gold 20 mg, 72.000 pieces, 20-40 my 40 my-meter in diameter (Berlock-Micro Micro-Implants, BMI, Goldtreat APS) were injected into the knee joint using the patient’s own synovial fluid as the carrier. Outcome measures were WOMAC pain, stiffness and function, PainDetect PainDetect questionnaire, and Q Quantitative Sensory Testing (QST) ( (pressure pain threshold assessed o over the knee joint) at inclu- sion and a after 8 weeks. Findings / Results: Pain and function improved in 25 of 30 patients. Womac pain decreased from 9 (6-16) to 3 (0-15), stiffness from 4 (1-8) to 2 (0-8), function from 29 (14-51) to 11 (0 51) to 11 (0-41), PainDetect from 10 (1- 26) to 3 (0-19), and pain pressure thresholds increased from 598 kPa (276- 1043) to 616 kPa (349-1089), all P < 0.05. Conclusions: Intra articular gold particles may modify the synovial inflamma- tion as a part of the sensitization in knee OA patients. Intra-articular metallic gold relieved pain and enhanced function in more than 80 % of the patients. This study suggests a basis for a future placebo controlled randomized trial in OA patients 202.