Knee Problems

Quick summary: In treating knee arthritis, the combination of PRP with hyaluronic acid (viscosupplimentation) was better than either PRP or HA alone. There was no differernce in risk or complications.

Full summary: Combination of PRP and HA led to improved WOMAC scores compared to PRP or HA alone, but no difference in Adverse Events

Quick summary: In a large study with over 1300 patients included, PRP decreased knee arthritis pain better than hyaluronic acid/viscosupplimentation.

Full summary: 15 RCTs (1,314 people) included in meta-analysis, PRP injections reduced pain more effectively than HA injections in patients with KOA at six and 12 months of follow-up, as evaluated by the WOMAC pain score; the VAS pain score showed a significant difference at 12 months. PRP didn’t display different adverse event rates compared with HA injections

Quick summary: MFAT (LipoGems) significantly decreased symptoms in patients with knee osteoarthritis. Side effects included soreness, pain, and stiffness following the injection.

Full summary: Eight studies (331 patients), mean differences in KOOS were 22.1, 19.5, 23.0, 30.8, 29.0, mean differences in pain scores between pre- and post-operation were -3.026, -2.523, -3.55, -4.15, and -2.13 (for VAS, VAS only, resting VAS, activity VAS, and NRS respectively), mean differences in QOL between pre- and post-operation were -25.10, 0.039, and 0.33 for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D, and University of California in Los Angeles (UCLA), respectively, the use of MFAT-MSCs was not associated with bruising, bleeding, hematoma, drainage, infection, and swelling but was associated with soreness, pain, and stiffness.

Quick summary: Knee osteoarthritis patients receiving BMAC (bone marrow aspiration concentrate) had significant improvement in outcome and decrease in pain at 12 months after treatment compared to patients receiving HA treatment (Hyaluronic acid / viscosupplimentation).

Full summary: One group received BMAC immediately followed by PRP, other group received a single injection of Gel-One crosslinked hyaluronate, Significant improvements were observed in both treatment groups for all Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales with the exception of the symptoms assessment at 12 months in the HA group, secondary outcomes included a greater reduction in pain at 12 months in the BMAC group (-3.13 points; 95% CI: -3.96, -3.29) compared to the HA group (-1.56 points; 95% CI: -2.59, -0.53; p= 0.02) via the numeric pain rating scale

Full summary: 15 studies with 463 patients (high, medium, low dose), QOL improved significantly, SF-36 scores after a year of follow-up [low dose: mean (M) = −23.99; 95% confidence interval (CI) [−31.49 to −16.49]; P < 0.001; medium dose: M = −15.96; 95% CI [−23.5 to − 8.42]; P < 0.001; high dose: M = −19.31; 95% CI [−28.02 to −10.59], P < 0.001], After six months, the low dosage group’s knee functions and activity levels improved significantly, as determined by the WOMAC physical function and stiffness subscales (M = −23.79; 95% CI [−38.43 to −9.16]; P = 0.001; M = −10.25; 95% CI [−17.31 to −2.59]; P < 0.01, respectively), as well as the KOOS scores after a year (P < 0.01 for all KOOS subscales)

Quick summary: PRP treatment in knee osteoarthritis had better long-term outcomes than steroid injection, although both showed improvement in pain and knee function for up to 5 weeks

Full summary: 40 patients, randomized into PRP group (n=20) and CS group (n=20). Both treatments were effective in relieving pain and improving the knee function in the very short-term follow-up visit (1 week). A high improvement of the subjective scores was observed for both groups up to 5 weeks, with no significant differences between the groups for the VAS, IKDC, or KSS. After 15 weeks of follow-up, the PRP group showed significant improvements in all scores when compared to the CS group. Overall, the patients who received PRP treatment had better outcomes in a longer follow-up visit (up to 1 year) than those who received CS.

Quick summary: 10 studies comparing BMAC (bone marrow aspirate concentrate) and SVF (stromal vascular fraction injection) in patients with knee osteoarthritis showed improvement in pain for both BMAC (5.8 to 2.6) and SVF (6.4 to 3.4). Although SVF had a greater effect of pain reduction than BMAC, complication were reported in 50% of BMAC and 67% of SVF studies.

Full summary: 10 studies with 472 patients (233 BMAC, 239 SVF), Patients who received an injection had improved VAS outcomes (mean ± SD): from 5.8 ± 1.3 to 2.6 ± 17 for BMAC and from 6.4 ± 1.4 to 3.4 ± 0.5 for SVF. SVF had greater effect on pain reduction than BMAC, but both significant, Complications were reported in 50% of the BMAC studies and 67% of the SVF studies

Quick summary: MFAT (LipoGems) significantly decreased symptoms in patients with knee meniscal tears in conjunction with osteoarthritis who had already failed conservative treatment including physical therapy.

Full summary: 20 subjects w/ knee pain secondary to osteoarthritis with associated meniscal tear after failed conservative management, mean NPS revealed significant decrease in patient pain after 1 year (5.45 to 2.21, p < .001), mean KOOS symptoms significantly improved from 57.7 to 78.2 (p < .001), safe and potentially efficacious