Editorial Commentary: Injection of Platelet-Rich Plasma Appears Superior to Hyaluronic Acid and Adipose- or Bone-Derived Marrow Stem Cells for Knee Osteoarthritis.

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)

Injection therapy for knee osteoarthritis continues to be a controversial topic. Commonly accepted treatment options are corticosteroid and hyaluronic acid injections, but recently platelet-rich plasma also has been a promising biologic treatment option. Adipose and bone marrow-derived mesenchymal stem cells have been applied clinically, but there is no strong supporting evidence for their use. It is also currently unknown whether stem cells can regenerate cartilage. As there is no cure for painful knee osteoarthritis, injection therapy can provide symptom relief. Recent network meta-analyses suggest that platelet-rich plasma provides the best functional improvement and safety for knee osteoarthritis, and adipose-derived mesenchymal stem cells provide excellent pain relief. We must bear in mind that other network meta-analyses report different results, and a challenge of network meta-analysis is inconsistency that can lead to biased treatment effect estimates.

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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