Related Experiment Video
Updated: Jun 2, 2025
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Amniotic Tissue Injections Are an Effective Alternative to Corticosteroid Injections for Pain Relief and Function in
Stephan G Pill1, Briggs Ahearn, John M Tokish
1From the Steadman Hawkins Clinic of the Carolinas, Prisma Health-Upstate, Greenville, SC (Dr. Pill, Dr. Ahearn, Dr. Siffri, Dr. Burnikel, Dr. Cassas, Dr. Wyland, and Dr. Kissenberth); the Mayo Clinic Arizona, Scottsdale, AZ (Dr. Tokish); the Department of Orthopaedics, Duke University, Durham NC (Dr. Cook); the Laboratory of Orthopaedic Tissue Regeneration & Orthobiologics, Department of Bioengineering, Clemson University, Clemson, SC (Dr. Mercuri, Mr. Sawvell, and Mr. Wright); the Frank H. Stelling and C. Dayton Riddle Orthopaedic Education and Research Laboratory, Clemson University Biomedical Engineering Innovation Campus, Greenville, SC (Dr. Mercuri, Mr. Sawvell, and Mr. Wright); and the Hawkins Foundation, Greenville, SC (Dr. Hutchinson, Dr. Bynarowicz, and Dr. Adams).
Introduction:
The use of corticosteroid injections for short-term pain relief for knee osteoarthritis can have deleterious adverse effects. Amniotic tissue has shown promise in vitro; therefore, this study compared a morcellized injectable amniotic tissue allograft to corticosteroid injection.
Methods:
Eighty-one patients with symptomatic severe knee osteoarthritis (Kellgren-Lawrence grade 3 to 4) were prospectively randomized to either a double-blinded single injection of BioDRestore (Integra LifeSciences; n = 39) or triamcinolone acetonide (n = 42). Knee Injury and Osteoarthritis Outcome Score (KOOS), Single Alpha Numeric Evaluation, visual analog scale (VAS) pain, Lysholm Rating, and Veterans-Rand-12 scales at baseline, 6 weeks, 3, 6, and 12 months were analyzed.
Results:
No differences were observed in adverse reactions or patient reported outcomes (PROs); however, a notable continued improvement was found in the amnion group from 6 weeks to 1 year for Single Alpha Numeric Evaluation, Lysholm, and KOOS Symptoms, Pain, activities of daily living [ADL], QofL. The minimal clinically important difference (MCID) was met for Lysholm, KOOS ADL, and KOOS pain.
Discussion:
Both amnion and steroid injections showed an initial improvement in pain relief and function at 6 weeks; however, more patients in the amniotic tissue group maintained pain relief and function at the 1-year follow-up. The mixed results suggest that amniotic tissue injections may be a safe and effective alternative to corticosteroid injections.
