Autologous conditioned serum
{{Short description|Treatment method using patient's own blood serum}}
Autologous conditioned serum, also known as Orthokine and Regenokine, is an experimental procedure in which a person's own blood is extracted, manipulated, and then reintroduced with claimed benefit in osteoarthritis. There is limited evidence on safety and effectiveness as of 2017.{{cite journal |last1=Wehling |first1=P |last2=Evans |first2=C |last3=Wehling |first3=J |last4=Maixner |first4=W |title=Effectiveness of intra-articular therapies in osteoarthritis: a literature review. |journal=Therapeutic Advances in Musculoskeletal Disease |date=August 2017 |volume=9 |issue=8 |pages=183–196 |doi=10.1177/1759720X17712695 |pmid=28835778| quote=Limited data due to less expanded use and nonconsideration in guidelines.|pmc=5557186 }} It is not included in medical guidelines as of 2017. It is a type of autologous blood therapy.
Medical use
There is limited evidence on safety and effectiveness as of 2017. There is tentative evidence in osteoarthritis.{{cite web |title=Osteoarthritis Emerging Therapies Epocrates Online |url=https://online.epocrates.com/diseases/19243/Osteoarthritis/Emerging-Therapies |website=online.epocrates.com |accessdate=30 September 2018}} Its use has not been recommended or considered by the Osteoarthritis Research Society International.
Process
The process removes about {{convert|2|USoz|ml}} of blood from a patient's arm, which is then incubated at a slightly raised temperature.{{citation needed|date=September 2018}} The liquid is then placed in a centrifuge until its constituent parts are separated. That serum is injected into the patient's affected area.
History
Autologous conditioned serum is a patented method developed by molecular biologist Julio Reinecke and Peter Wehling, a spinal surgeon in Düsseldorf, Germany.{{cite news|last=Kyler|first=Steve|title=NBA AM: The Next Nightmare In The NBA|date=August 15, 2012|work=hoopsworld.com|publisher=USA Today|url=http://www.hoopsworld.com/nba-am-the-next-nightmare-in-the-nba/|archiveurl=https://web.archive.org/web/20120816170933/http://www.hoopsworld.com/nba-am-the-next-nightmare-in-the-nba|archivedate=2012-08-16|url-status=live|access-date=2012-08-17}}{{cite news|url=http://articles.nydailynews.com/2011-12-31/news/30577759_1_balco-founder-victor-conte-renna-patrick-arnold|title=A-Rod doc has pal who dealt 'cream'|last=Thompson|first=Teri|date=December 31, 2011|newspaper=New York Daily News|archive-url=https://archive.today/20130208154656/http://articles.nydailynews.com/2011-12-31/news/30577759_1_balco-founder-victor-conte-renna-patrick-arnold|archive-date=2013-02-08|url-status=dead|access-date=2012-08-14}} Orthokine was first approved for use in Germany in 2003.{{cite news|last=Mitchell|first=John N.|title=Bynum's knee treatment gains acceptance in U.S.|date=August 18, 2012|newspaper=The Philadelphia Inquirer|url=http://articles.philly.com/2012-08-18/sports/33249379_1_regenokine-andrew-bynum-joint-replacement|archive-url=https://web.archive.org/web/20150914185251/http://articles.philly.com/2012-08-18/sports/33249379_1_regenokine-andrew-bynum-joint-replacement|archive-date=2015-09-14|url-status=dead|access-date=2012-08-25}} Orthokine differs from a similar procedure with platelet-rich plasma (PRP),{{cite journal | title=New developments in the treatment of osteoarthritis – focus on biologic agents | last1=Torrero | first1=JI | last2=Martinez | first2=C | journal= Open Access Rheumatology: Research and Reviews| volume=7 | issue=7 | pages=33–43 | date=July 2015 | pmid=27790043 | pmc=5045124 | doi=10.2147/OARRR.S50058 | doi-access=free }} where platelets are targeted instead of the interleukin antagonist. Also, PRP does not require the blood to be heated as Orthokine does.{{citation needed|date=September 2018}}
As of August 2012, about 60,000 patients worldwide have received the treatment. Americans have traveled to Germany for the treatment, which has not been approved by the U.S. Food and Drug Administration (FDA).{{cite news|last=Lehrer|first=Jonah|title=Why Did Kobe Go to Germany?|date=April 11, 2012|work=grantland.com|publisher=ESPN Internet Ventures|url=http://www.grantland.com/story/_/id/7796225/kobe-bryant-dr-chris-renna-regenokine-knee-treatment|archiveurl=https://web.archive.org/web/20120828001611/http://www.grantland.com/story/_/id/7796225/kobe-bryant-dr-chris-renna-regenokine-knee-treatment|archivedate=2012-08-28|url-status=live|access-date=2012-08-14}} Freddie Fu, a professor of orthopedic surgery at the University of Pittsburgh, said more high-quality independent trials proving the procedure's effectiveness are needed before the FDA approves. National Basketball Association player Kobe Bryant traveled to Germany to have the procedure performed. Some basketball fans refer to the procedure as the "Kobe Procedure".
The procedure costs €6,000 (about $7,400) as of July 2012 and is not covered by health insurance.