Veronesi Francesca, Andriolo Luca, Salerno Manuela, Boffa Angelo, Giavaresi Gianluca, Filardo Giuseppe
Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
J Clin Med. 2023 Dec 22;13(1):67. doi: 10.3390/jcm13010067.
The use of minimally manipulated adipose tissue (MM-AT) products is gaining increasing interest for the treatment of knee osteoarthritis (OA). MM-AT represents an easy way to exploit adipose tissue properties, although clinical evidence is still limited, as well as their benefits with respect to more documented orthobiologics like platelet-rich plasma (PRP). A systematic review and meta-analysis were performed to evaluate the safety and efficacy of MM-AT products for knee OA management. The risk of bias of the included studies was evaluated using the Dawns and Black checklist for all the included studies and RoB-2.0 for randomized controlled trials (RCTs). Thirty-three clinical studies were included in the qualitative analysis: 13 prospective case series, 10 retrospective case series, 7 RCTs, 2 retrospective comparative studies, and 1 prospective comparative study. An overall clinical improvement and few minor adverse events were observed. Five RCTs comparing MM-AT and PRP injections were meta-analyzed, showing comparable results. The analysis also highlighted the limits of the literature, with only a few high-level trials and an overall low quality. Even though the current literature is still limited, the available evidence suggests the safety and overall positive results of the intra-articular injections of MM-AT products for knee OA treatment.
使用微处理脂肪组织（MM-AT）产品治疗膝关节骨关节炎（OA）越来越受到关注。MM-AT是一种利用脂肪组织特性的简便方法，尽管临床证据仍然有限，而且与记录更详尽的诸如富血小板血浆（PRP）等骨科生物制剂相比，其益处也不明确。进行了一项系统综述和荟萃分析，以评估MM-AT产品治疗膝关节OA的安全性和有效性。使用Dawns和Black清单对所有纳入研究进行偏倚风险评估，对随机对照试验（RCT）使用RoB-2.0进行评估。定性分析纳入了33项临床研究：13项前瞻性病例系列、10项回顾性病例系列、7项RCT、2项回顾性比较研究和1项前瞻性比较研究。观察到总体临床改善且不良事件较少。对5项比较MM-AT和PRP注射的RCT进行了荟萃分析，结果显示二者相当。分析还突出了文献的局限性，只有少数高水平试验且总体质量较低。尽管目前的文献仍然有限，但现有证据表明关节内注射MM-AT产品治疗膝关节OA具有安全性和总体积极效果。
