MESOTHERAPY COMBINED WITH REGENERATIVE MEDICINE. A NEW APPROACH FOR NOCICEPTIVE PAIN TREATMENT IN PATIENTS WITH OSTEOARTHROSIS

Regenerative medicine focuses on repairing or restoring damaged tissues by promoting the biological activity of cells at the target site. This goal is achieved through the in vivo stimulation of cellular mechanisms responsible for tissue regeneration, often mediated by the administration of biofunctional molecules.1 The drug Placentex (Mastelli S.r.l., Italy), based on polydeoxyribonucleotide (PDRN), was used in the present study. In musculoskeletal disorders such as arthritis, pain often results from peripheral tissue inflammation (nociceptive pain) and may be accompanied by nerve damage or dysfunction (neuropathic pain). These pain types often coexist. No universally accepted standard of care exists due to the multiple pain mechanisms involved and the wide range of therapeutic options for chronic pain. The high incidence of adverse events associated with nonsteroidal anti-inflammatory drugs has led to increased interest in alternative treatments. If effective and well-tolerated, local pharmacological therapy is a viable alternative to systemic NSAIDs.2 Our study included patients with nociceptive pain of arthritic origin, localized in the hand and wrist joints. The group consisted of ten patients—nine women and one man—who were able to independently complete the DASH questionnaire we administered, all reporting pain with an NRS score > 7. One patient was diagnosed with Charcot-Marie-Tooth disease, nine had fibromyalgia, seven had shoulder osteoarthritis, and eight suffered from anxiety-depressive syndrome. The follow-up period ranged from 3 to 12 months. At baseline (T0), the DASH-FS scores indicated high levels of disability (90.35, 88.17-94.35). Following treatment (T1), scores significantly improved (57.65, 47.02 - 61.50). The difference in scores between T0 and T1 showed a consistent reduction (-35.00, -27.65 - -39.85). The Wilcoxon signed-rank test confirmed a statistically significant improvement in upper limb function (p = 0.0059). Our findings demonstrate that mesotherapy with PDRN is a viable and effective therapeutic option for patients with hand and wrist osteoarthritis, offering substantial improvements in function and reduction in pain. The observed benefits likely result from both the regenerative properties of PDRN and the localized, sustained release of the active agents at the site of pathology. We can assume that mesotherapy, especially when combined with regenerative agents such as Placentex, may represent an effective and well-tolerated option for the management of localized osteoarticular pain. Despite the limited sample size and the exploratory nature of our study, the results highlight the therapeutic potential of PDRN in mesotherapy, especially in patients refractory to conventional treatments. Further large-scale controlled studies are needed to validate these preliminary results and define standardized protocols for clinical practice. It should also be noted that this type of treatment is almost completely free of side effects, also considering that patients who benefit from it often present important comorbidities.