Complication rates of bone marrow aspirate concentrate injections versus other injectable therapies for knee osteoarthritis: A systematic review and meta-analysis.

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)

Background Complications of bone marrow aspirate concentrate (BMAC) injections for knee osteoarthritis (OA) are not well known and were investigated through comparison to other injections. Methods PubMed, Embase, Cochrane, and Web of Science databases were searched for randomized controlled trials (RCTs) comparing isolated BMAC injections to other injectables for knee OA. Demographics, complications, and comparator injectable treatments were collected. Complication rates and number needed to harm (NNH) were calculated for BMAC. DerSimonian-Laird random-effects models evaluated differences in pooled early (≤7 days) and late (>7 days) complication rates using odds ratios. Results Six RCTs were identified with 860 patients, 334 of whom received BMAC injections. The mean follow-up was 13 months. The overall complication rates among BMAC and comparison groups were 41.91 % and 41.25 %, respectively (p = 0.85). The NNH for BMAC was 152. Knee effusion was the most common complication of BMAC (18.26 %). Early and late complication rates for BMAC were not significantly different from other injectables (hyaluronic acid [HA], steroids, platelet-rich plasma, stromal vascular fraction, mesenchymal stromal cells, or saline) (early p = 0.09, I 2 = 0; late p = 0.46, I 2 = 0), nor specifically compared to HA (early p = 0.76, I 2 = 0; late p = 0.66, I 2 = 0). Conclusions Complication rates of BMA

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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