Fucaloro Stephen, Bragg Jack T, Feldman Matthew W, Krivicich Laura, Salzler Matthew J
Department of Orthopaedic Surgery, Tufts Medical Center, Boston, MA, 02111, USA.
Tufts University School of Medicine, Boston, MA, 02111, USA.
J Orthop. 2024 Oct 11;62:36-42. doi: 10.1016/j.jor.2024.10.005. eCollection 2025 Apr.
Complications of bone marrow aspirate concentrate (BMAC) injections for knee osteoarthritis (OA) are not well known and were investigated through comparison to other injections.
PubMed, Embase, Cochrane, and Web of Science databases were searched for randomized controlled trials (RCTs) comparing isolated BMAC injections to other injectables for knee OA. Demographics, complications, and comparator injectable treatments were collected. Complication rates and number needed to harm (NNH) were calculated for BMAC. DerSimonian-Laird random-effects models evaluated differences in pooled early (≤7 days) and late (>7 days) complication rates using odds ratios.
Six RCTs were identified with 860 patients, 334 of whom received BMAC injections. The mean follow-up was 13 months. The overall complication rates among BMAC and comparison groups were 41.91 % and 41.25 %, respectively (p = 0.85). The NNH for BMAC was 152. Knee effusion was the most common complication of BMAC (18.26 %). Early and late complication rates for BMAC were not significantly different from other injectables (hyaluronic acid [HA], steroids, platelet-rich plasma, stromal vascular fraction, mesenchymal stromal cells, or saline) (early p = 0.09, = 0; late p = 0.46, = 0), nor specifically compared to HA (early p = 0.76, = 0; late p = 0.66, = 0).
Complication rates of BMAC injections are not significantly different from other injectables, nor specifically from HA for knee OA. Compared to other injections, 152 patients would need to receive a BMAC injection for one additional patient to experience a complication.
骨髓抽吸浓缩物（BMAC）注射治疗膝关节骨关节炎（OA）的并发症尚不为人所知，本研究通过与其他注射疗法对比进行了调查。
检索PubMed、Embase、Cochrane和Web of Science数据库，查找比较单纯BMAC注射与其他用于膝关节OA的注射剂的随机对照试验（RCT）。收集人口统计学数据、并发症以及对照注射剂治疗情况。计算BMAC的并发症发生率和伤害所需人数（NNH）。采用DerSimonian-Laird随机效应模型，使用优势比评估汇总的早期（≤7天）和晚期（>7天）并发症发生率的差异。
确定了6项RCT，共860例患者，其中334例接受了BMAC注射。平均随访时间为13个月。BMAC组和对照组的总体并发症发生率分别为41.91%和41.25%（p = 0.85）。BMAC的NNH为152。膝关节积液是BMAC最常见的并发症（18.26%）。BMAC的早期和晚期并发症发生率与其他注射剂（透明质酸[HA]、类固醇、富血小板血浆、基质血管成分、间充质基质细胞或生理盐水）相比无显著差异（早期p = 0.09，I² = 0；晚期p = 0.46，I² = 0），与HA相比也无特异性差异（早期p = 0.76，I² = 0；晚期p = 0.66，I² = 0）。
BMAC注射的并发症发生率与其他注射剂相比无显著差异，与用于膝关节OA的HA相比也无特异性差异。与其他注射疗法相比，每增加1例发生并发症的患者，需要152例患者接受BMAC注射。
