Ningxia Medical University, The General Hospital of Ningxia Medical University, 804 Shengli South Street, Yinchuan, 750004, Ningxia Hui Autonomous Region, China.
Institute of Medical Sciences, General Hospital of Ningxia Medical University, 804 Shengli South Street, Yinchuan, 750004, Ningxia, China.
Arthritis Res Ther. 2023 Aug 10;25(1):147. doi: 10.1186/s13075-023-03134-3.
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).
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.
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).
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.
评估单次和多次关节内注射自体脂肪来源的干细胞（ASCs）和脂肪来源的基质血管部分（ADSVF）治疗膝骨关节炎（OA）的疗效。
我们对多个数据库（包括 PubMed、Embase、Web of Science、Cochrane 图书馆和 ClinicalTrials.gov）进行了全面和系统的搜索，以确定相关研究。纳入的研究为随机对照试验（RCTs），涉及单次或多次关节内注射自体 ASCs 或 ADSVF 治疗膝骨关节炎患者，无任何额外治疗，并与安慰剂或透明质酸进行比较。
本研究共分析了 7 项 RCT。荟萃分析结果显示，与对照组相比，单次和多次关节内注射 ASCs 或 ADSVF 均在短期（Z=3.10；P<0.0001 和 Z=4.66；P<0.00001）内显著缓解疼痛，并显著改善功能（Z=2.61；P<0.009 和 Z=2.80；P=0.005）。此外，与对照组相比，MRI 评估显示软骨状况有显著改善。（Z=8.14；P<0.000001 和 Z=5.58；P<0.00001）。
总之，在膝关节骨关节炎中，单次或多次关节内注射自体 ASCs 或 ADSVF 在无辅助治疗的情况下，短期内可显著改善疼痛并具有安全性。软骨状态也有显著改善。需要更大样本量的随机对照试验来直接比较单次和多次注射效果的差异。
