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

Sampson MJ, Kabbani M, Krishnan R, et al. · BMC Musculoskeletal Disorders

Five weeks after the first injection, MRI showed complete resolution of the bone marrow lesions at the medial femoral condyle and tibial plateau and a smaller effusion; pain fell from 8/10 to 0 and the Lysholm knee score rose from 37 to 65 by four weeks after the last injection. The patient had failed intra-articular corticosteroid, had a prior partial meniscectomy with a recurrent tear, and was on the waiting list for a knee replacement.

Population

70-year-old woman with knee OA and bone marrow edema lesion

Intervention

PPS 2 mg/kg intramuscular twice weekly for 3 weeks (six injections), with no NSAIDs or other treatment during the course

Comparator

None

Limitations

Single patient with no control; the pre- and post-treatment scans used different MRI sequences (2D proton density against 3D SPACE), which the authors argue is unlikely to have biased the reading; drug supplied by Paradigm Biopharmaceuticals, and one author is a Paradigm employee.