DOI: 10.36347/sjams.2024.v12i05.016

Pages: 607-616

Background: Stem cells and exosomes offer a non-surgical approach to treating osteoarthritis (OA). Exosomes play an essential role in intercellular communication that has been widely studied. Furthermore, multi-wavelength intra-articular laser therapy is a newly developed technique in the treatment of various diseases. Here, we investigated the therapeutic potential and mechanism of adipose tissue-derived exosomes to alleviate knee osteoarthritis compared with exosome therapy combined with intra-articular laser therapy. Method: Adipose-derived exosomes were isolated and purified. Five volunteers received intra-articular injection of autologous exosomes in the right knee, while the left knee of these volunteers received intra-articular exosome injection and intra-articular infrared laser, 808 nm. To avoid any bias in the patient, the laser fiber was passed through the inserted needle for exosome injection, but without radiation, and on the right knee, an invisible infrared laser was applied. Visual analog scales (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were collected the week before the procedure, and every month until the sixth months after injection for both knees. Discussion: Both intra-articular exosome injections improved pain and functional outcomes at 6-month follow-up in volunteers with knee osteoarthritis. The differences between exosome injection and exosomes combined with intra-articular laser therapy are in terms of clinical improvement rates and functional outcome rates. Conclusion: Combination of stemcell or exosome therapy with intra-articular laser therapy could be considered as a feasible option in non-surgical treatment approaches. It could be also used as a preventive purpose.