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      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

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          Abstract

          Objective

          Assess the efficacy of single and multiple intra-articular injections of autologous adipose-derived stem cells (ASCs) and adipose-derived stromal vascular fraction (ADSVF) for the treatment of knee osteoarthritis (OA).

          Methods

          We conducted a thorough and systematic search of several databases, including PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov, to identify relevant studies. The included studies were randomized controlled trials (RCTs) that involved single or multiple intra-articular injections of autologous ASCs or ADSVF for the treatment of patients with knee osteoarthritis, without any additional treatment, and compared to either placebo or hyaluronic acid.

          Results

          A total of seven RCTs were analyzed in this study. The results of the meta-analysis show that compared to the control group, both single and multiple intra-articular injections of ASCs or ADSVF demonstrated superior pain relief in the short term ( Z = 3.10; P < 0.0001 and Z = 4.66; P < 0.00001) and significantly improved function ( Z = 2.61; P < 0.009 and Z = 2.80; P = 0.005). Furthermore, MRI assessment showed a significant improvement in cartilage condition compared to the control group. ( Z = 8.14; P < 0.000001 and Z = 5.58; P < 0.00001).

          Conclusions

          In conclusion, in osteoarthritis of the knee, single or multiple intra-articular injections of autologous ASCs or ADSVF have shown significant pain improvement and safety in the short term in the absence of adjuvant therapy. Significant improvements in cartilage status were also shown. A larger sample size of randomized controlled trials is needed for direct comparison of the difference in effect between single and multiple injections.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13075-023-03134-3.

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          Most cited references27

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          Measuring inconsistency in meta-analyses.

          Julian P. T. Higgins, Simon Thompson, Jonathan Deeks … (2003)
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            Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

            David Moher, Larissa Shamseer, Mike Clarke … (2017)
            Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
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              The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.

              Alessandro Liberati, Douglas G. Altman, Jennifer Tetzlaff … (2009)
              Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement-a reporting guideline published in 1999-there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (www.prisma-statement.org) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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                Author and article information

                Contributors
                Yang Yang: 931627803@qq.com
                Zhibin Lan: lzb360999@126.com
                Jiangbo Yan: yanjiangbo2022@163.com
                Zhiqun Tang: tang20210110397@126.com
                Linghui Zhou: 1072654306@qq.com
                Dian Jin: 1799683216@qq.com
                Qunhua Jin: jinqunhua2020@163.com
                Journal
                Journal ID (nlm-ta): Arthritis Res Ther
                Journal ID (iso-abbrev): Arthritis Res Ther
                Title: Arthritis Research & Therapy
                Publisher: BioMed Central (London )
                ISSN (Print): 1478-6354
                ISSN (Electronic): 1478-6362
                Publication date (Electronic): 10 August 2023
                Publication date PMC-release: 10 August 2023
                Publication date (Print): 2023
                Volume: 25
                Electronic Location Identifier: 147
                Affiliations
                [1 ]GRID grid.412194.b, ISNI 0000 0004 1761 9803, Ningxia Medical University, The General Hospital of Ningxia Medical University, ; 804 Shengli South Street, Yinchuan, 750004 Ningxia Hui Autonomous Region China
                [2 ]GRID grid.413385.8, ISNI 0000 0004 1799 1445, Institute of Medical Sciences, General Hospital of Ningxia Medical University, ; 804 Shengli South Street, Yinchuan, 750004 Ningxia China
                [3 ]GRID grid.412194.b, ISNI 0000 0004 1761 9803, Ningxia Medical University, Lingwu People’s Hospital Affiliated to Ningxia Medical University, ; Lingwu, 750004 Ningxia China
                [4 ]GRID grid.412194.b, ISNI 0000 0004 1761 9803, Ningxia Medical University, ; Yinchuan, 750004 Ningxia China
                Article
                Publisher ID: 3134
                DOI: 10.1186/s13075-023-03134-3
                PMC ID: 10413774
                PubMed ID: 37563715
                SO-VID: 7560c03c-9be7-448a-9841-8f601c9df1b8
                Copyright © © BioMed Central Ltd., part of Springer Nature 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 24 May 2023
                Date accepted : 2 August 2023
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2023

                ScienceOpen disciplines: Orthopedics
                Keywords: adipose-derived stem cells,knee osteoarthritis,stromal vascular fraction
                Data availability:
                ScienceOpen disciplines: Orthopedics
                Keywords: adipose-derived stem cells, knee osteoarthritis, stromal vascular fraction

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