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Musculoskeletal and Sports Medicine

Efficacy of Autologous Adipose-Derived Cell Therapy Compared to Non-Active Controls in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Original Research Theater
Disclosure(s):
Antonio Madrazo Ibarra, MD: No financial relationships to disclose
Daniel De La Huerta Meza, MD: No financial relationships to disclose
Vijay Vad, MD: No financial relationships to disclose
Background and/or Objectives: Knee osteoarthritis is a leading cause of pain and disability. While conservative and surgical treatments are commonly used, regenerative therapies such as adipose-derived cell therapies (ADCTs) have emerged as potential disease-modifying alternatives. However, the clinical effectiveness of ADCTs compared to placebo or no treatment remains unclear.

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).

Setting : Peer-reviewed RCTs assessing the efficacy of ADCTs for knee osteoarthritis.

Participants : Studies included adults diagnosed with knee osteoarthritis based on radiologic or clinical criteria. All included trials compared intra-articular ADCTs to placebo injections or no active treatment.

Interventions: The intervention group received autologous ADCTs delivered intra-articularly. Control groups received either saline injections or no intra-articular treatment.

Main Outcome Measures: The primary outcome was pain reduction at 6 months, measured by patient-reported outcome measures including the Numeric Pain Rating Scale (NPRS), KOOS Pain subscale, and WOMAC Pain subscale. Secondary outcomes included function (e.g., KOOS-ADL, WOMAC Function), quality of life (KOOS-QoL), and sports activity (KOOS-Sports).

Results: A total of 8 RCTs (590 patients) were included. Meta-analyses demonstrated a statistically significant reduction in pain at six months in favor of ADCTs. The WOMAC Pain subscale showed a mean difference (MD) of −1.75 (95% confidence interval [CI] −2.62 to −0.88, p = 0.013), the NPRS showed an MD of −1.42 (95% CI −2.67 to −0.17, p = 0.035), and the KOOS Pain subscale showed an MD of 7.95 (95% CI 0.98 to 14.93, p = 0.033). These findings were consistent with low to moderate heterogeneity. Functional improvements and QoL benefits were also observed at multiple time points, though effect sizes varied. Most outcomes favored the ADCT group.

Conclusions: ADCTs significantly reduce knee pain at 6 months compared to placebo or no treatment, with consistent improvements in function. These findings support the use of ADCT as a promising non-surgical option for managing symptomatic knee osteoarthritis.