SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07121556 (Randomized Double- Blind Study on the Treatment of Symptomatic Bilateral Knee Osteoarthritis), which is not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Double- Blind Study on the Treatment of Symptomatic Bilateral Knee Osteoarthritis: Intra-articular Injection of Autologous Microfragmented Adipose Tissue and Hyaluronic Acid vs Intra Articular Injection of Autologous Microfragmented Adipose Tissue. Double-Blind Randomized Controlled Clinical Trial
Who cites it
32 citing papers in PubMed, 5 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Are orthobiologics a plausible therapeutic option for patello-femoral pathology? A systematic review of clinical and radiological outcomes.Frontiers in bioengineering and biotechnology · 2026Pooled it
- Cell-based therapies have disease-modifying effects on osteoarthritis in animal models: A systematic review by the ESSKA Orthobiologic Initiative. Part 3: Umbilical cord, placenta, and other sources for cell-based injectable therapies.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Pooled it
- Biological intra-articular augmentation for osteotomy in knee osteoarthritis: strategies and results : A systematic review of the literature from the ESSKA Orthobiologics Initiative.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 2: bone marrow-derived cell-based injectable therapies.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Intra-articular injection of umbilical cord-derived mesenchymal stem cells is safe and effective for moderate to severe knee osteoarthritis with synovitis: a double‑blinded and randomized controlled trial.BMC musculoskeletal disorders · 2025Trial
- Cell-based therapy injections for the management of knee osteoarthritis: The ESSKA-ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- A single intra-articular stromal vascular fraction with platelet-rich plasma injection yields superior clinical outcomes than a hyaluronic acid injection in patients with knee osteoarthritis: A prospective comparative study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Decellularized extracellular matrix restores Fibronectin/Integrin β1 balance through extracellular vesicles to rejuvenate chondrocytes and alleviate osteoarthritis progression.Journal of orthopaedic translation · 2026Article
- The use of injectable orthobiologics for knee osteoarthritis: A formal ESSKA-ORBIT consensus. Part 2-Cell-based therapy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Micro-fragmented adipose tissue for the treatment of hip osteoarthritis: A prospective pilot study at 1-year follow-up.Journal of experimental orthopaedics · 2025Article
- Effect of corticosteroids and hyaluronic acid injections on knee osteoarthritis trajectory.Journal of experimental orthopaedics · 2025Article
- Sex differences in intra-articular treatment outcomes for knee osteoarthritis: Current evidence and research gaps: A systematic review and meta-analysis.Journal of experimental orthopaedics · 2025Article
- Side-to-side characterisation of cellular content, soluble factors and in vitro potential on chondrocytes for bone marrow aspirate concentrate and adipose-derived stromal vascular fraction.Journal of experimental orthopaedics · 2025Article
- Adipose-derived mesenchymal stem cells combined with platelet-rich plasma are superior options for the treatment of osteoarthritis.Journal of orthopaedic surgery and research · 2025Article
- Arthroscopic debridement followed by intra-articular injection of micro-fragmented adipose tissue in patients affected by knee osteoarthritis: Clinical results up to 48 months from a prospective clinical study.Journal of experimental orthopaedics · 2025Article
- 3D connective micro-fragment enriched with stromal vascular fraction in osteoarthritis: chondroprotective evidence in a preclinicalFrontiers in cell and developmental biology · 2025Article
- Secretome and extracellular vesicle signatures in bone marrow-derived mesenchymal stromal cells after expansion in standard and next-generation media.Extracellular vesicles and circulating nucleic acids · 2025Article
- Adipose-derived stem cells and knee osteoarthritis: New perspectives, old concerns.World journal of orthopedics · 2024Article
- Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence.EFORT open reviews · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this systematic review was to determine if adipose tissue-derived cell-based injectable therapies can induce disease-modifying effects in joints affected by osteoarthritis (OA).
methodsA systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical studies comparing injectable adipose-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE's tool.
resultsSeventy-one studies were included (2,086 animals) with an increasing publication trend over time. Expanded cells were used in 65 studies, 3 studies applied point of care products, and 3 studies investigated both approaches. Overall, 48 out of 51 studies (94%) reported better results with adipose-derived products compared to OA controls, with positive findings in 17 out of 20 studies (85%) in macroscopic, in 37 out of 40 studies (93%) in histological, and in 22 out of 23 studies (96%) in immunohistochemical evaluations. Clinical and biomarker evaluations showed positive results in 14 studies out of 18 (78%) and 12 studies out of 14 (86%), while only 9 studies out of 17 (53%) of the imaging evaluations were able to detect differences versus controls. The risk of bias was low in 38% of items, unclear in 51%, and high in (11%).
conclusionThe current preclinical models document consistent evidence of disease-modifying effects of adipose-derived cell-based therapies for the treatment of OA. The high heterogeneity of the published studies highlights the need for further targeted research to provide recommendations on the optimal methodologies for a more effective application of these injective therapies for the treatment of OA in clinical practice. LEVEL OF EVIDENCE: II.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.