Intra-articular Orthobiologics Show Statistically but Not Clinically Meaningful Improvements Compared With Viscosupplementation in Knee Osteoarthritis: A Network Meta-analysis of Randomized Controlled Trials.

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 evaluate the comparative effectiveness of intra-articular platelet-rich plasma (PRP), stromal vascular fraction (SVF), bone marrow aspirate concentrate (BMAC), umbilical cord-derived mesenchymal stem cell (UC-MSC), and hyaluronic acid (HA) for pain relief and functional improvement in patients with knee osteoarthritis through network meta-analysis. Methods A systematic search was conducted using major biomedical databases to identify randomized controlled trials that compared the clinical efficacies of PRP, SVF, BMAC, UC-MSC, and HA. The clinical scores for pain and function were standardized for network meta-analysis based on minimal clinically important differences. Results Twenty-four studies, with 2960 patients, were included. SVF and BMAC showed significantly greater reductions in pain scores than HA at 3, 6, and 12 months (mean difference [MD], -0.7 to -1.1), whereas UC-MSC and PRP showed modest or nonsignificant effects (MD, -0.3 to -0.7). Functional outcomes showed a similar trend, with SVF and BMAC producing the greatest improvements (MD, -0.6 to -1.4), followed by UC-MSC and PRP (MD, -0.3 to -0.9). However, the magnitude of change in both pain and function did not exceed the minimal clinically important difference. At the final follow-up, SVF had the highest surface under the cumulative ranking curve, followed by BMAC and UC-MSC, with PRP ranking lower and

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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