WHAT IS AUTOLOGOUS CONDITIONED SERUM?
Autologous conditioned serum (ACS) is a blood-derived cell-free treatment that is rich in anti-inflammatory components including growth factors and cytokines that can help with pain and inflammation. Some of these components in ACS have also been associated with inhibiting the destruction of cartilage and other joint structures as well as tissues such as tendons and ligaments. The main component of ACS is interleukin-1 receptor antagonist (IL-1ra) which can limit the activity of one of the main powerful pro-inflammatory signaling proteins, interleukin-1 (IL-1). IL-1 has been associated with the destruction of cartilage along with causing joint and tissue inflammation. Some of the other components found in ACS include:
| Protein | Physiologic effects |
|---|---|
| Interleukin-1 receptor antagonist (IL-1ra) | Blocks the IL-1 inflammatory cytokine. |
| IL-4 | Inhibits IL-1, TNFα, and MMP production; reduces nitric oxide. |
| Interleukin-10 (IL-10) | Suppresses inflammatory cytokines TNFα, IL-1, and IL-6, which can contribute to tissue damage. |
| IL-13 | Inhibits IL-1 and TNFα, suppresses cartilage catabolism, and reduces nitric oxide. |
| IGF-1, TGFβ, EGF, bFGF, PDGF | Anabolic growth factors. |
HOW DOES ACS WORK?
Autologous conditioned serum (ACS) is a concentration of various cytokines and growth factors from blood that have individually shown to help with decreasing existing pro-inflammatory mediators in the joint and tissues. Decreasing pro-inflammatory and catabolic proteins such as interleukin-1 (IL-1), tumor necrosis factor alpha (TNF⍺), and interleukin-6 (IL-6), matrix metalloproteinases (MMP-1, MMP-3, MMP-9, MMP-13) can help decrease pain and inflammation. By modifying the inflammatory environment in the joint, ACS can assist with protecting joint tissues such as cartilage as well as muscle, tendons, and ligaments. The addition of growth factors can also assist with the anti-inflammatory effects and promote tissue healing.
BENEFITS OF ACS:
Autologous conditioned serum (ACS) is a non-surgical treatment option that can naturally provide anti-inflammatory effects long term. It can reduce pain and swelling and can assist with improved function. By reducing certain inflammatory proteins such as IL-1, ACS can reduce the presence of harmful proteins that break down cartilage, ligaments, and tendons thus providing disease-modifying effects and contribute to tissue repair and integrity.
WHO IS A CANDIDATE FOR ACS?
Ideal candidates for autologous conditioned serum injections are individuals seeking a non-surgical solution for pain relief and tissue healing. These include people with chronic joint pain, arthritis, chondromalacia (cartilage damage), meniscus tears, labral tears, ligament sprains and tears, and tendinosis and tendon partial tears. ACS may be helpful in situations where traditional treatments such as rest, medications, chiropractic care, acupuncture, and physical therapy have not helped. Candidates may be seeking an alternative to surgery. A formal consultation with Dr. Yoon will be needed to determine if this treatment is appropriate.
WHAT CAN I EXPECT WITH ACS TREATMENT?
The consultation with Dr. Yoon will consist of a thorough evaluation and discussion. Dr. Yoon’s office will also provide a pre and post treatment guideline handout if treatment is pursued. Most treatments require abstaining from the use of non-steroidal anti-inflammatory medications (NSAIDs) one week before and two weeks after the procedure to allow the treatments to naturally work. Because many treatment protocols are tailored to the specific needs of the patient, expectations post treatment will be carefully explained beforehand. Necessary prescriptions for orthotics and other braces, biomechanics evaluations, physical therapy prescriptions, specific location and provider referrals, and other needs will be provided. Continuous patient follow-up will occur at specific timepoints to optimize treatment results.
WHY CHOOSE DR. STEVE YOON FOR ACS?
Dr. Steve Yoon is a highly regarded biologics expert utilizing autologous conditioned serum (ACS) treatments in professional sports making him a top choice for ACS therapy for patients in Los Angeles and around the country. He has extensive experience utilizing ACS while in his role as Director of Clinical Regenerative Medicine at the Cedars Sinai Kerlan Jobe Institute and as a treating consultant for the vast majority of professional sports teams and sports agencies throughout the country. Dr. Yoon has successfully treated patients over two decades while specializing in the use of ACS and other regenerative therapies to enhance recovery and performance. His personalized and tailored approach with patients and helping them with their quality of life has earned him numerous honors including being recognized annually in Los Angeles as a Super Doctor as well as a Top Doctor nationally by Castle Connolly.
RESEARCH ARTICLES
Fudalej P, Witkowski G, Kowalewski P. A comprehensive evaluation and meta-analysis of the efficacy of autologous conditioned serum in knee osteoarthritis. AAEM Medicine & Biology. 2023; (article ID: 2). doi:10.5604/01.3001.0014.1167
Vitali M, Ometti M, Drossinos A, Pironti P, Santoleri L, Salini V. Autologous conditioned serum: clinical and functional results using a novel disease modifying agent for the management of knee osteoarthritis. J Drug Assess. 2020;9(1):43-51. doi:10.1080/21556660.2020.1734009
Raeissadat SA, Rayegani SM, Sohrabi MR, Jafarian N, Bahrami MN. Effectiveness of intra-articular autologous-conditioned serum injection in knee osteoarthritis: a meta-analysis study. Future Sci OA. 2021;7(9):FSO759. doi:10.2144/fsoa-2021-0069
Simon MJK, Aartsen VE, Coghlan JA, Strahl A, Bell SN. Shoulder injections with autologous conditioned serum reduce pain and disability in glenohumeral osteoarthritis: longitudinal observational study. ANZ J Surg. 2021;91(4):673-679. doi:10.1111/ans.16672
Leone R, De Rosa A, Iudicone P, et al. Pain control and functional improvement in patients treated by autologous conditioned serum after failure of platelet-rich plasma treatments in knee osteoarthritis. Transfus Med. 2021;31:357-364. doi:10.1111/tme.12801
Damjanov N, Zekovic A, et al. Intra-articular autologous conditioned serum and triamcinolone injections in patients with knee osteoarthritis: a controlled, randomized, double-blind study. J Int Med Res. 2023;51(10):3000605231203851
Coşkun HS, Yurtbay A, Say F. Platelet rich plasma versus autologous conditioned serum in osteoarthritis of the knee: clinical results of a five-year retrospective study. Cureus. 2022;14(4):e24500. doi:10.7759/cureus.24500
Vitali M, Ometti M, Pironti P, Salvato D, Sandrucci A, Leone O, Salini V. Clinical and functional evaluation of bone marrow aspirate concentrate vs autologous conditioned serum in the treatment of knee osteoarthritis. Acta Biomed. 2022;93(5):e2022222. doi:10.23750/abm.v93i5.12845
Damjanov N, Barac B, Colic J, Stevanovic V, Zekovic A, Tulic G. Intra-articular autologous conditioned serum and triamcinolone injections in patients with knee osteoarthritis: a controlled, randomized, double-blind study. J Int Med Res. 2023;51:3000605231203851. doi:10.1177/03000605231203851
Jeyaraman N, Jeyaraman M, Ramasubramanian S, et al. Autologous conditioned serum in knee osteoarthritis: a systematic review of current clinical evidence. Cureus. 2024;16(9):e68963. doi:10.7759/cureus.68963