Evidence map›Paper›PMID 40938868›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

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.

Trifon Totlis, Vlasios Achlatis, Panagiotis-Konstantinos Emfietzis, Theodorakys Marín Fermín, Theodoros Pettas, Aristotelis Sideridis, Ioannis Terzidis

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Trifon TotlisSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID https://orcid.org/0000-0001-5729-7755
Vlasios AchlatisSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID https://orcid.org/0009-0002-6897-367X
Panagiotis-Konstantinos EmfietzisSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID https://orcid.org/0009-0002-2630-2552
Theodorakys Marín FermínThessaloniki Minimally Invasive Surgery (The-MIS) Orthopaedic Centre, St. Luke's Hospital, Thessaloniki, Greece.ORCID https://orcid.org/0000-0002-1698-9517
Theodoros PettasSchool of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.ORCID https://orcid.org/0009-0004-6486-2870
Aristotelis SideridisThessaloniki Minimally Invasive Surgery (The-MIS) Orthopaedic Centre, St. Luke's Hospital, Thessaloniki, Greece.
Ioannis TerzidisThessaloniki Minimally Invasive Surgery (The-MIS) Orthopaedic Centre, St. Luke's Hospital, Thessaloniki, Greece.ORCID https://orcid.org/0000-0001-6530-2833

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe present study aimed to compare the efficacy and safety of a combined injection of stromal vascular fraction (SVF) and platelet rich plasma (PRP) versus a high molecular weight (HMW) hyaluronic acid (HA) injection in patients with knee osteoarthritis (KOA).

methodsA prospective comparative analysis was conducted for patients with KOA who underwent either a single intra-articular mechanical SVF combined with PRP injection (Group A) or a single intra-articular injection of HMW HA (Group B). The Knee Injury and Osteoarthritis Outcome Score (KOOS), the visual analogue scale (VAS) and the EuroQol EQ-5D (EQ-5D-5L) were assessed at baseline, 3, 6 and 12 months postinjection. PRP was coded according to the DEPA classification.

resultsThe study included 108 knees from 67 patients (Group A: 31; Group B: 36). The VAS, KOOS total and EQ-5D-5L scores significantly improved within each group in every timepoint compared to baseline. The SVF-PRP group significantly outperformed the HMW-HA group in VAS, KOOS total and EQ-5D-5L scores at 6 months and 12 months follow-up. The proportion of patients who achieved Minimal Clinically Important Difference (MCID) at 12 months was 87.0% versus 57.4% (p = 0.0003) in KOOS, 74.1% versus 61.1% in VAS (p = 0.152) and 64.8% versus 40.7% (p = 0.005) in EQ-5D-5L, for the SVF-PRP vs HA group, respectively. No serious adverse events were reported in either group. Minor local adverse events were more common in the SVF-PRP group and spontaneously resolved within days. The implemented PRP was coded as CCA.

conclusionBoth SVF-PRP and HA injections are safe treatments, with no serious adverse events, and significantly improve pain, function and quality of life in patients with KOA. The SVF-PRP outperformed the HA group in all three PROMs at 6 months and 12 months follow-up, and in the proportion of patients who achieved MCID at 12 months postinjection. LEVEL OF EVIDENCE: Level II.

Indexed as

Hyaluronic AcidOsteoarthritis, KneePlatelet-Rich PlasmaStromal Vascular FractionViscosupplementsAgedFemaleHumansInjections, Intra-ArticularMaleMiddle AgedPain MeasurementProspective StudiesTreatment OutcomeHyaluronic AcidViscosupplementsadipose‐derived stem cellshyaluronic acidknee osteoarthritisplatelet rich plasmastromal vascular fraction

Identifiers

PMID40938868
PMCPMC13418390

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Registered trials

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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.