Level A· Stronger Clinical Evidence
Intra-articular Injection of Autologous Adipose-Derived Stem Cells or Stromal Vascular Fractions: Are They Effective for Patients With Knee Osteoarthritis? A Systematic Review With Meta-analysis of Randomized Controlled Trials
Kim K.I., Kim M.S., Kim J.H.
Pooled five RCTs comparing ADSC/SVF injection with placebo or hyaluronic acid, finding significant pain and function improvement at 6 and 12 months.
- Study type
- Meta-analysis
- Journal
- The American Journal of Sports Medicine (2023)
- Country
- South Korea
- Sample size
- —
- Follow-up
- 6–12 months
- PMID
- 35019764
- DOI
- 10.1177/03635465211053893
What was studied
Efficacy and safety of autologous ADSC and SVF injections without adjuvant treatment in knee osteoarthritis.
Methods
- • Searched MEDLINE, Embase, Web of Science and the Cochrane Library, restricted to RCTs.
- • Outcomes: 100-mm VAS for pain, WOMAC for function, MRI for cartilage status.
Key findings
- • Significant pain relief at 6 months (Z = 7.62) and 12 months (Z = 7.21).
- • Significant functional improvement at 6 and 12 months.
- • Subgroup analysis showed similar efficacy between ADSC and SVF, with no serious adverse events.
Limitations
- • Only five RCTs, all with short-term follow-up.
- • MRI outcomes could not be pooled due to heterogeneous assessment.
What this study does not prove
- • Evidence for cartilage regeneration remains very limited.
- • This study does not prove SVF is an approved treatment or a replacement for standard care.
- • Limited follow-up cannot indicate long-term outcomes.
Clinical interpretation
Level 1 evidence supporting short-term symptom benefit, but silent on durability and structural change.
Evidence level: Stronger Clinical Evidence