Autologous adipose-derived mesenchymal stromal cell injection for knee osteoarthritis improves pain and function without a clear increase in adverse events: A systematic review and meta-analysis of randomized controlled

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Purpose To systematically review randomized controlled trials and quantitatively evaluate the efficacy and safety of injections of autologous adipose-derived mesenchymal stromal cells (AD-MSCs) in patients with knee osteoarthritis (OA). Methods Multiple electronic databases were searched with no date restrictions for randomized controlled trials evaluating intra-articular autologous adipose-derived cell products for knee OA. The stromal vascular fraction was considered biologically distinct and was not pooled for the same intervention. The primary efficacy outcomes were the pain visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores. Safety outcomes were defined by the occurrence of any adverse events (AEs) and serious AEs (SAEs). A random-effects meta-analysis was performed. Results Of the 1178 identified records, six randomized controlled trials, including 551 patients, were included. Compared with control, AD-MSC treatment was associated with lower WOMAC total scores at 3 months (mean difference [MD], -8.14; 95% confidence interval [CI], -13.33 to -2.95) and 6 months (MD, -8.07; 95% CI, -13.60 to -2.54), and lower pain VAS scores at 3 months (MD, -1.49; 95% CI, -2.45 to -0.54), 6 months (MD, -1.40; 95% CI, -2.08 to -0.73) and 12 months (MD, -1.80; 95% CI, -3.20 to -0.41). The pooled risk of any AEs was not signific

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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