Center for Orthopedic and Sports Injuries

Orthokine® – Autologous osteoarthritis therapy

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Orthokine serum is an autologous injection solution derived from the patient’s blood. It may be used for the treatment of osteoarthritis and nerve root inflammation of different origin, such as disc prolapse. The basic idea for the development of this therapy was the fact that interleukin-1 (IL-1) plays a key role in the pathology of osteoarthritis or intervertebral disc degeneration/prolaps. The biological antagonist, interleukin-1 receptor antagonist (IL-1Ra), intervenes in the physiological mechanism of these diseases.

Interleukin-1-receptor antagonist (IL-1Ra) is naturally present in the blood. However, this antagonist is produced and extracted in higher concentrations with the production of Orthokine. To do this, blood is taken from the patient with a special syringe. During incubation at 37°C, the monocytes present in the blood are stimulated to produce IL-1Ra. This protein is then extracted, filled into ampoules and is subsequently available as an injectable substance for clinical use.

This cannot be compared to treatments using the patient’s own blood that are often used in alternative medicine.

The Orthokine procedure is used throughout the world by more than 500 orthopaedic surgeons and rheumatologists. In Germany alone, more than 20,000 patients have been treated with Orthokine serum. Various clinical studies verify the high effectiveness and safety of this procedure.

Osteoarthritis therapy with Orthokine

Körpereigene Schutzproteine werden direkt in das schmerzende Gelenk gespritztOsteoarthritis is characterised by the degeneration process in the joint. This leads to the progressive destruction of the joint cartilage until, in the final stage, the joint is unable to perform it’s natural function. The cause for the reduction of the cartilage that acts as a natural shock absorber and enables untroubled movement is a low grade inflammatory process in the joint. Interleukin-1 (IL-1) is responsible for the destruction of the cartilage tissue and is present in small but still aggressive concentrations in osteoarthritis.

To protect the cartilage tissue, the interleukin-1-receptor antagonist (IL-1Ra) protein is extracted from the patient’s blood and injected into the joint.

Orthokine therapy has a high success rate, particularly for osteoarthritis of the knee joint and hip. Fast pain and inflammation reduction has been observed in about 75% of patients. In addition, the joint function improves.

Orthokine therapy has been used on approximately 20,000 patients in Germany. No serious side-effects or allergic reactions have been observed as the medication is produced without any additives. There are positive experiences with the Orthokine biotechnical treatment of osteoarthritis since 1998. An extensive clinical study for osteoarthritis treatment with Orthokine is currently under way. The first results are expected early 2005.

Orthokine concept

Orthokine – autologous medicine for inflammation

Interleukin-1 (rote Kugel) schädigt die Knorpelzellen
Interleukin-1 (red spheres)
damages and destroys cells

Orthokin is an autologous treatment concept used by doctors for the treatment of arthritis and spinal disorders. This concept is based on the finding that the cytokine Interleukin-1 (IL-1) is a key factor in the destruction of cartilage and the development of osteoarthritis (OA). Therefore, therapy of OA using an IL-1 blocker such as Interleukin-1 Receptor Antagonist (IL-1Ra) appears logical. IL-1Ra is antiinflammatory, relieves pain and is chondroprotective.

In the case of OA and spinal disorders we see a (sometimes low grade) inflammation of the painful site. IL-1 (red spheres) is the most prominent active agent in this process. It damages and destroys cells by occupation of it’s specific receptors.

IL-1Ra (blaue Kugel) schützt die Knorpelzellen vor dem aggressiven IL-1 (rote Kugel).

Antagonist (blue spheres) has occupied the receptorsIL-1Ra, present in Orthokine serum, (blue spheres) inhibits inflammation. If present in excess with respect to IL-1, it competitively occupies the receptors in the affected site. Thereby IL-1 is unable to attatch to the receptors and elicit it’s proinflammatory, destructive and painful effects. The tissue and the cells are thereby protected from further destruction.

Interleukin-1-Receptor Antagonist (blue spheres) has occupied the receptors. IL-1 is kept away and the inflammation process is blocked.


The Orthokine procedure includes withdrawing blood from the patient with the specialized Orthokine syringe. The white blood cells contained in this blood begin immediately to produce IL-1Ra and other antiinflammatory and regenerative proteins. The concentration of the lead substance IL-1Ra increases up to 140 fold compared to normal basal levels. Without any further additives, the Orthokine serum is extracted, filtered and filled into ampoules. The subsequent therapy includes about 6 injections (given once or twice weekly).

Orthokine Treatment Is Effective For Knee Arthritis, Even After Two Years – Long-Study Confirms Effectiveness Of Autologous Therapy

The results of a two-year representative study of osteoarthritis of the knee, published in the internationally renowned journal “Osteoarthritis and Cartilage”, confirm the safety and effectiveness of Orthokine therapy, in which anti inflammatory proteins obtained from the patient’s own blood are injected into the arthritic joint.

Researchers at Heinrich Heine University in Düsseldorf conducted a long-term study to determine the most effective treatment for osteoarthritis of the knee joint. They compared the effects of injections of Orthokine, hyaluronic acid and placebo in 310 arthritis patients over a two-year period. Hyaluronic acid, a joint lubricant, is widely used to treat arthritis. Saline was used as the placebo. “The two-year results confirm our previous studies: Orthokine therapy provides long-term relief from pain and joint dysfunction in many patients and does so more effectively than comparable treatments”, said Prof. Peter Wehling, chairman of the board of Orthogen AG, on Friday in Düsseldorf.

Two years after the series of injections, patients treated with Orthokine scored substantially better than those treated with hyaluronic acid or placebo on measures of pain and joint function. “Long-term treatment effects take on particular importance for patients suffering from arthritis, since this is a chronic condition. Improvement in the symptoms of osteoarthritis means an improvement in patients’ quality of life”, notes study physician Carsten Moser, MD. The results are also of wider interest as arthritis affects at least 200 million people worldwide. Arthritis treatments whose effectiveness is highly controversial and that, according to the World Health Organization (WHO), in some cases can result in serious side effects.

Two-year results

Two years after the initial treatment, 188 of the 310 patients were still reporting improvements with respect to pain and joint function, while 122 had sought other treatments in the meantime such as surgery, injections, medication or acupuncture. The number of patients requiring further treatment was smallest in the Orthokine group. Two years after treatment, improvement was still measurable in all three groups. A clear difference was seen, however, in scores on the WOMAC test, a questionnaire measuring joint function and quality of life. From a initial score of around 124, the Orthokine group scored 58 on the WOMAC after two years, with marked improvements in joint function and mobility, while the comparison groups scored substantially higher at 88 and 84 while the hyaluronic acid and placebo groups scored substantially higher at 88 and 84 respectively. “Orthokine treatment is a safe, long-lasting alternative to conventional methods”, said Moser. On the visual analog scale (VAS) that measures pain from 0 (no pain) to 100 (most intense pain imaginable), the average pain intensity prior to treatment was 70. Two years after treatment, the VAS score of the Orthokine group was 30 (mild pain). Pain intensity in the other two groups was 39 in the hyaluronic acid group and 37 in the placebo group.

The GOAT study (German Osteoarthritis Trial), a randomized, prospective, placebo-controlled trial, initially included 376 men and women with an average age 58. Two years later, 310 participants agreed to take part in a follow-up examination. The main inclusion criterion of the osteoarthritis study was chronic knee pain due to osteoarthritis of the knee. Participants were randomly allocated to one of three treatment groups that received injections of Orthokine, hyaluronic acid or salt solution (placebo). Treatment consisted of six sessions over three weeks. After six weeks, three months, six months (double blinded) and 24 months (single blinded), the patients underwent a full examination. The examination included the administration of internationally recognized pain measurement instruments such as the visual analog scale (VAS) and the WOMAC questionnaire.

Autologous arthritis treatment based on protective proteins

Orthokine therapy was developed by Düsseldorf orthopaedic surgeon Dr. Peter Wehling and molecular biologist Dr. Julio Reinecke. It is based on an understanding of the biological mechanisms that lead to of osteoarthritis and pain. In osteoarthritis, the body produces interleukin-1 (IL-1), a protein that contributes to the breakdown of cartilage. To slow down or stop this process, the biological adversary of IL-1, the interleukin-1 receptor antagonist (IL-1Ra), is used. IL-1Ra neutralizes the effect of IL 1, and has anti-inflammatory, analgesic and cartilage-protective effects. In the Orthokine method, various anti-flammatory proteins and growth factors such as IL-1Ra are obtained from the patient’s own blood and injected back into the affected joint.


“Osteoarthritis and Cartilage” is a respected scientific journal (impact factor 4.017) that publishes only original, peer-reviewed research into new methods for the treatment of diseases of the locomotor system. For further information please visit:

Orthogen AG




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