Injections of autologous adipose-derived stem cells (ASCs) and adipose-derived stromal vascular fraction (ADSVF) for treatment of knee osteoarthritis (OA) demonstrated significant short-term pain relief and safety without the need for additional therapy, according to study results published in Arthritis Research & Therapy.
Investigators conducted a meta-analysis of randomized control trials (RCTs) to evaluate the effectiveness of intra-articular injections of autologous ASCs or ADSVF for knee OA treatment. The results were compared with placebo or hyaluronic acid, without additional treatment (control group).
Both single and multiple intra-articular injections of ASCs or ADSVF demonstrated superior performance compared with the control group. Notably, these injections provided significant short-term pain relief (ASC: Z = 3.10; P<.0001; ADSVF: Z = 4.66; P <.00001) and led to significant improvements in function (ASC: Z = 2.61; P <.009; ADSVF: Z = 2.80; P =.005).
Magnetic resonance imaging assessment revealed a significant improvement in the condition of the cartilage following treatment with ASCs or ADSVF compared against the control group (ASC: Z = 8.14; P <.000001; ADSVF: Z = 5.58; P <.00001).
Postsurgical knee pain or swelling was observed in both the treatment and control groups at a rate of 46%. The combined hazard ratio estimate was 1.04 (95% CI, 0.82-1.31; I² = 41%; Z = 0.30), indicating no significant difference between the 2 groups (P =.77). Additionally, there were no reports of any significant adverse events associated with ASC or ADSVF treatment.
Mean visual analog scale (VAS) scores showed improvement ranging from 24.6 to 36.9 at 6 months and 22.7 to 42.0 at 12 months among the single injection and 2 to 3 injection groups. In contrast, the control group demonstrated a mean VAS score improvement of 0.6 to 6.0 at 6 months and 0.6 to 5.9 at 12 months.
Subgroup analysis of ASCs and ADSVF revealed that the ADSVF group had a significantly higher total Western Ontario and McMaster Universities Osteoarthritis Index score compared with the control group after 6 months. However, there was no significant difference observed in the results of the ASC group.
The study authors concluded, “A larger sample size of randomized controlled trials
is needed for direct comparison of the difference in effect between single and multiple injections.”
Yang Y, Lan Z, Yan J, et al. Effect of intra-knee injection of autologous adipose stem cells or mesenchymal vascular components on short-term outcomes in patients with knee osteoarthritis: an updated meta-analysis of randomized controlled trials. Arthritis Res Ther. Published online August 10, 2023. doi:10.1186/s13075-023-03134-3