Autologous conditioned serum in the therapy of obesity-related knee osteoarthritis

Authors

  • G. Kotov Clinic of Rheumatology, “Sv. Ivan Rilski” University Hospital – Sofia, Bulgaria; Department of Rheumatology, Medical Faculty, Medical University – Sofia, Bulgaria Author
  • P. Ermencheva Clinic of Rheumatology, “Sv. Ivan Rilski” University Hospital – Sofia, Bulgaria Author
  • R. Shumnalieva Department of Rheumatology, Medical Faculty, Medical University – Sofia, Bulgaria; Clinic of Rheumatology, “Sv. Anna” University Hospital – Sofia, Bulgaria Author
  • G. P. Georgiev Department of Orthopedics and Traumatology, University Hospital Queen Giovanna – ISUL, Medical Faculty, Medical University – Sofia, Bulgaria Author https://orcid.org/0000-0001-8343-0337
  • A. Zaralieva Department of Kinesiotherapy, Faculty of Public Health, Health Care and Sports, South-West University “Neofit Rilski” – Blagoevgrad, Bulgaria Author
  • S. Monov Department of Rheumatology, Medical Faculty, Medical University – Sofia, Bulgaria; Clinic of Rheumatology, “Sv. Anna” University Hospital – Sofia, Bulgaria Author

DOI:

https://doi.org/10.2478/AMB-2026-0056

Keywords:

obesity-related knee osteoarthritis, autologous conditioned serum, intra-articular injection, pain, knee function, treatment

Abstract

Abstract. Introduction: Knee osteoarthritis (KOA) is a common joint disorder affecting the elderly population. Conservative treatment includes lifestyle modifications, weight loss, physiotherapy, nonsteroidal anti-inflammatory drugs, chondroprotective agents, intra-articular application of steroids, hyaluronic acid, and autologous blood component injections. Obesity-related KOA has recently been extensively studied as a separate disease, and there are currently no explicit guidelines regarding its treatment. Currently, there is only a few literature data on the intra-articular administration of autologous conditioned serum (ACS) in subjects with KOA, which suggests an improvement in pain management and functional impairment. However, no separate studies have been performed for obesity-related KOA. Therefore, the aim of our study was to evaluate the efficacy and safety of ACS in the treatment of obesity-related KOA. Materials and methods: A total of 20 patients with Kellgren-Lawrence (KL) grade 2-3 obesity-related KOA were included in the present study, all of whom received intra-articular ACS. Demographic data and routine laboratory examinations were performed and musculoskeletal ultrasound was used to assess for synovitis prior to intervention. Pain and functional impairment were assessed through visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) prior to intervention, 1 week and 6 months post-treatment. Results: We reported a statistically significant decrease in pain and functional improvement 1 week post-treatment, which persisted up to 6 months post-treatment. Better improvement was noted in KL grade 2 and in subjects with synovitis. There were no major adverse events reported. Conclusions: The intra-articular administration of ACS provides rapid improvement of pain and functional impairment in obesity-related KOA, which persists up to 6 months post-treatment.

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Published

10.06.2026

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Section

ORIGINAL ARTICLES

How to Cite

Kotov, G., Ermencheva, P., Shumnalieva, R., Georgiev, G. P., Zaralieva, A., & Monov, S. (2026). Autologous conditioned serum in the therapy of obesity-related knee osteoarthritis. Acta Medica Bulgarica, 53(2), 29-35. https://doi.org/10.2478/AMB-2026-0056

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