Safety and Efficacy of Intra-articular Cell-Free Fat Extract Injection in Patients With Symptomatic Knee Osteoarthritis

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• 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 Cell-free fat extract (CEFFE) has shown promising therapeutic effects on osteoarthritis (OA) in preclinical studies, but its clinical role remains unclear. Purpose To evaluate the safety and efficacy of intra-articular autologous CEFFE injections for symptomatic early- and mid-stage knee OA. Study design Randomized controlled trial; Level of evidence, 2. Methods A total of 24 participants were randomly allocated to 1 of 4 groups to receive 5 weekly injections of (1) hyaluronic acid (HA, active comparator), (2) low-dose CEFFE (containing 1 mL CEFFE), (3) medium-dose CEFFE (containing 1.5 mL CEFFE), or (4) high-dose CEFFE (containing 2 mL CEFFE). Autologous CEFFE was prepared by spin, emulsification, and filtration after abdominal liposuction, effectively removing lipid and cellular components. Information regarding adverse effects was collected. Routine blood tests, C-reactive protein levels, liver function tests, and kidney function tests were performed at baseline and at the 24-week follow-up to assess systemic toxic effects of CEFFE injection. The clinical effectiveness of CEFFE injections was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores. Magnetic resonance imaging (MRI) was used to detect changes in bone marrow lesions (BMLs) and cartilage loss at baseline and at the final follow-up

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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