Adipose-Derived Cell Therapies Versus Nonactive Controls for Knee Osteoarthritis: A Systematic Review and...

The aim of the study was to compare adipose-derived cell therapies versus nonactive controls in treating knee osteoarthritis.

This systematic review and meta-analysis included randomized controlled trials comparing adipose-derived cell therapies with placebo or no treatment in patients with knee osteoarthritis. Two reviewers extracted study, patient, and intervention data, as well as patient-reported outcomes. Random-effects meta-analyses were performed for outcomes reported in at least three studies. The primary outcome was pain improvement at 6 mos, with secondary outcomes including function, quality of life, and adverse events.

Eight randomized controlled trials (585 patients) were included. Adipose-derived cell therapies showed superior pain improvement versus controls at 6 mos, with WOMAC Pain (MD = -1.75, 95% CI = -2.62 to -0.88) and KOOS Pain (MD = 7.95, 95% CI = 0.98 to 14.93) achieving statistical significance. Functional outcomes also improved significantly, while quality of life favored adipose-derived cell therapy but did not reach significance. No serious adverse events occurred, although two patients reported severe events after adipose-derived cell therapy.

At 6 mos, adipose-derived cell therapies provided greater pain relief and functional improvement than nonactive controls, although no benefit was observed for quality-of-life. Severe adverse events were uncommon, but additional studies are needed for long-term efficacy and safety.