Adipose-derived Cell Therapies versus Non-Active Controls for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: To compare adipose-derived cell therapies (ADCTs) versus non-active controls in treating knee osteoarthritis. DESIGN: This systematic review and meta-analysis included randomized controlled trials (RCTs) comparing ADCTs 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 six months, with secondary outcomes including function, quality of life, and adverse events. RESULTS: Eight RCTs (585 patients) were included. ADCTs showed superior pain improvement versus controls at six months, 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 ADCT but did not reach significance. No serious adverse events occurred, although two patients reported severe events after ADCT. CONCLUSIONS: At six months, ADCTs provided greater pain relief and functional improvement than non-active controls, though no benefit was observed for quality-of-life. Severe adverse events were uncommon, but additional studies are needed for long-term efficacy and safety.

VIVO Weill Cornell Medical College