Shoulder injections with autologous conditioned serum reduce pain and disability in glenohumeral osteoarthritis: longitudinal observational study

Background Currently, non-surgical treatments for glenohumeral osteoarthritis (GH-OA) mainly aim to reduce pain. Autologous conditioned serum (ACS), Orthokine, an interleukin-1 inhibitor from the patient's own blood has an anti-inflammatory effect. The objective was to determine whether intra-articular injections of this ACS improved symptoms in patients with GH-OA and delayed the need for a shoulder replacement. Methods A total of 36 consecutive patients, 40 shoulders, with OA received up to 6-weekly intra-articular injections of ACS were included. Imaging of GH-OA, range of motion, visual analogue scale (VAS) pain, Shoulder Pain And Disability Index (SPADI), American Shoulder and Elbow Surgeons and Constant scores were assessed pre-injection and post treatment at 3 months. At a minimum of 2 years, VAS and SPADI scores and whether anyone had progressed to a shoulder replacement were recorded. Results Outcomes 3 months post-ACS injections demonstrated on average statistically significant improvement (P < 0.05) of all measurements: SPADI (54.3 +/- 21.5 vs 43.7 +/- 23.7), Constant score (50.5 +/- 14.1 vs 57.1 +/- 17.4), VAS pain (4.8 +/- 2.2 vs 3.7 +/- 2.4) and range of motion. Of these, 16 shoulders progressed to a shoulder replacement, nine cases quickly (0.6 +/- 0.2 years) and seven cases were delayed by 3.1 +/- 1.7 years. The other 18 cases had significant improvement in pain, SPADI (58.0 +/- 19.6 to 31.8 +/- 21.4; P < 0.01) scores and no progression to a shoulder replacement at 3.6 +/- 1.0 years follow-up. There was no correlation of glenoid Walch score or joint space with clinical outcome parameters. Conclusion ACS injections in the shoulder joint for OA can reduce pain and disability, and postpone the need for a shoulder replacement.

Automated summary

The study showed that intra-articular injections of ACS in patients with GH-OA can improve pain and function, delaying the need for a shoulder replacement. Some patients demonstrated significant pain improvement and avoided shoulder replacement surgery at two-year follow-up.