Intra-Articular Application of Autologous, Fat-Derived Orthobiologics in the Treatment of Knee Osteoarthritis: A Systematic Review.
Matthias HolzbauerEleni PriglingerStig-Frederik Trojahn KølleLukas PrantlChristian StadlerPhilipp Wilhelm WinklerTobias GotterbarmDominik DuscherPublished in: Cells (2024)
The aim of this study was to review the current literature regarding the effects of intra-articularly applied, fat-derived orthobiologics (FDO) in the treatment of primary knee osteoarthritis over a mid-term follow-up period. A systematic literature search was conducted on the online databases of Scopus, PubMed, Ovid MEDLINE, and Cochrane Library. Studies investigating intra-articularly applied FDO with a minimum number of 10 knee osteoarthritis patients, a follow-up period of at least 2 years, and at least 1 reported functional parameter (pain level or Patient-Reported Outcome Measures) were included. Exclusion criteria encompassed focal chondral defects and techniques including additional arthroscopic bone marrow stimulation. In 28 of 29 studies, FDO showed a subjective improvement in symptoms (pain and Patient-Reported Outcome Measures) up to a maximum follow-up of 7.2 years. Radiographic cartilage regeneration up to 3 years postoperatively, as well as macroscopic cartilage regeneration investigated via second-look arthroscopy, may corroborate the favorable clinical findings in patients with knee osteoarthritis. The methodological heterogeneity in FDO treatments leads to variations in cell composition and represents a limitation in the current state of knowledge. However, this systematic review suggests that FDO injection leads to beneficial mid-term results including symptom reduction and preservation of the affected joint in knee osteoarthritis patients.
Keyphrases
- knee osteoarthritis
- patient reported
- systematic review
- end stage renal disease
- bone marrow
- newly diagnosed
- ejection fraction
- chronic kidney disease
- chronic pain
- healthcare
- single cell
- prognostic factors
- peritoneal dialysis
- pain management
- randomized controlled trial
- mesenchymal stem cells
- social media
- depressive symptoms
- neuropathic pain
- fatty acid
- high resolution
- combination therapy
- deep learning
- meta analyses
- replacement therapy
- smoking cessation
- mass spectrometry
- rotator cuff
- case control