Management of Degenerative Knee Disease With Bone Marrow Aspirate Concentrate and Intermittent Platelet-Based Therapy: Nearly Nine Years of Follow-Up

Meniscal injury and degenerative knee disease are common causes of chronic pain and functional limitation.Although bone marrow aspirate concentrate (BMAC) and platelet-based therapies have been investigated as nonsurgical treatment options, long-term clinical outcomes remain insufficiently characterized.We report the nearly nine-year clinical course of a 45-year-old male with longstanding bilateral knee pain, a left medial meniscal tear with an associated parameniscal cyst, and bilateral patellofemoral degenerative changes documented on serial pre-treatment magnetic resonance imaging.Before treatment in December 2017, the patient reported severe activity-related pain (approximately 9/10) and walking tolerance of approximately 0.2 miles.He underwent an initial bone marrow-based orthobiologic intervention involving BMAC, followed by super-concentrated platelet (SCP) and platelet lysate (PLM) treatment and subsequent periodic SCP/PLM maintenance injections.The patient retrospectively reported progressive symptomatic improvement during the first nine months.At nearly nine years, immediately before his September 2026 maintenance injection, he verbally reported a pain intensity of 0/10 during routine daily activities.He reported walking approximately 2.4 miles daily, the ability to walk up to five miles, and an estimated 95% overall improvement.Interpretation is limited by retrospective outcome assessment, the absence of post-treatment imaging, repeated maintenance injections, and substantial weight reduction of approximately 25%.This case illustrates sustained patient-reported functional improvement during a longitudinal orthobiologic treatment regimen but cannot establish treatment-specific efficacy or structural regeneration.Prospective studies incorporating standardized functional assessments, serial imaging, and documentation of concurrent interventions are needed.