Table 1.

Summary of the included studies

Author(s), Year Country	Research design	Participant characteristics			Intervention group					Control group	Adverse events (n)		Follow-Up (month)
		Sample size N(I/C)	Age (mean ± SD/median [IQR])	K-L Grade	Source (donor)	Dose (ADMSCs)	Extracted amount (cc/ml)	Delivery method and Frequency	Procedure	Procedure	Intervention group	Control group
Autologous-culture
[46] Brazil	RCT	26 (6*/6/6/8*) *Patients were divided into 4 groups: 6 in ADMSC and 8 in the control	I: 58.5 ± 6.17 C: 41 ± 4.67	2 to 4	abdomen	1 × 107	200	Injection Once	Arthroscopic debridement Cultured ADMSCs	Arthroscopic debridement	Not reported	Not reported	6
[15] Korea	RCT	26 (13/13)	I: 58.3 ± 6.4 C: 59.1 ± 5.9	2 to 4	abdomen	10 × 107	20	Injection Once	HTO Cultured ADMSCs	HTO	No treatment-related adverse events	No adverse events	24
[47] Italy	RCT	38 (19/19)	I: 55.8 C: 56.4	Outerbridge 4	N/A	N/A	N/A	Injection Once	Arthroscopic debridement Arthroscopic microfracture PRP Cultured ADMSCs	Arthroscopic debridement Arthroscopic microfracture PRP	Pain and swelling (3)	Pain and swelling (2)	12
[48] China	RCT	30 (10*/10/10*) *Patients were divided into 3 groups: 10 in ADMSC and 10 in the control	I: 62 ± 8.33 C: 59.7 ± 7.12 *femoro-tibial cartilage defect	3	abdomen	5 × 107	50	Injection Twice (day1, 22)	Arthroscopic debridement Arthroscopic microfracture Hyaluronic acid Cultured ADMSCs	Arthroscopic debridement Arthroscopic microfracture Hyaluronic acid	Joint effusion/swelling (3) Sciatic pain (2) Low back pain (1) Skin erythema (2)	Joint effusion/swelling (1) Sciatic pain (2) Low back pain (3) Skin erythema (1)	24
[49] Australia	RCT	30 (10/10/10)	Ione: 54.6 ± 6.3 Itwo: 54.7 ± 10.2 C: 51.5 ± 6.1	2 to 3	abdomen	10 × 107	60	Injection Once Twice (0, 6 months)	Ione: One cultured ADMSCs at baseline Itwo: Two cultured ADMSCs at baseline and 6 months	Conventional management (simple analgesia, weight management, and exercise)	Minor discomfort and bruising at the fat collection site Discomfort and/or swelling Swelling and pain impacting usual daily activity (2)	No adverse events	12
[50] Korea	RCT	24 (12/12)	I: 62.2 ± 6.5 C: 63.2 ± 4.2	2 to 4	abdomen	10 × 107	20	Injection Once	Cultured ADMSCs	Saline	Arthralgia (6) Joint effusion (2)	Joint effusion (1)	6
[51] China	RCT	52 (26/26)	I: 55.03 ± 9.19 C: 59.64 ± 5.97	1 to 3	abdomen	5 × 107	50	Injection Twice (0, 3 weeks)	Cultured ADMSCs	Hyaluronic acid	Transient pain and swelling (19)	Transient pain and swelling (14) Study withdrawal due to infection of the knee joint (1)	12
[52] Japan	Non-RCT (retrospective)	80 (42/38)	Iculture: 70.0 ± 9.1 ISVF: 73.0 ± 9.1	2 to 4	abdomen	Iculture: 1.28 × 107 ISVF: Unknown	Iculture: 20 ISVF: 200	Injection Iculture: Twice** ISVF: Once	Iculture: Cultured ADMSCs ISVF: SVF		Iculture Death (1) Gastric cancer (1) Knee pain and swelling (9) Induration at the fat collection site (2) ISVF Knee effusion and swelling (3) Pain at the fat collection site (6) Bleeding at the fat collection site (5) Induration at the fat collection site (12)	N/A	24
[16] Japan	Non-RCT (retrospective)	80 (42/38)	Iculture: 70.0 ± 9.1 ISVF: 73.0 ± 9.1	2 to 4	abdomen	Iculture: 1.28 × 107 ISVF: Unknown	Iculture: 20 ISVF: 200	Injection Once	Iculture: Cultured ADMSCs ISVF: SVF		Iculture Knee effusion and swelling (1) Induration at the fat collection site (2) ISVF Knee effusion and swelling (3) Pain at the fat collection site (6) Bleeding at the fat collection site (5) Induration at the fat collection site (12)	N/A	Not reported
[53] China	RCT	18 (6/6/6)	Ilow: 52.1 ± 11.6 Imed: 59.6 ± 10.2 Ihigh: 52.7 ± 8.7	2 to 3	abdomen	Ilow: 1 × 107 Imed: 2 × 107 Ihigh: 5 × 107	50	Injection Twice (3, 6 weeks)	Cultured ADMSCs		Ilow Swelling (7) Imiddle Pain (2) Swelling (5) Ihigh Pain (2) Swelling (4)	N/A	24
[54] Korea	Non-RCT	18 (3/3/12)	Ilow: 63 ± 8.6 Imed: 65 ± 6.6 Ihigh: 61 ± 6.2	3 to 4	abdomen	Ilow: 1 × 107 Imed: 5 × 107 Ihigh: 10 × 107	N/A	Injection Once	Cultured ADMSCs		No treatment-related adverse events	N/A	24
[55] France	Non-RCT	18 (6/6/6)	Ilow: 63.2 ± 4.1 Imed: 65.5 ± 8.1 Ihigh: 65.2 ± 2.3	3 to 4	abdomen	Ilow: 0.2 × 107 Imed: 1 × 107 Ihigh: 5 × 107	60 g	Injection Once	Cultured ADMSCs		Ilow Joint effusion and swelling (2) Imiddle No treatment-related adverse events Ihigh Joint effusion and swelling (3)	N/A	6
[56] Korea	Non-RCT	18 (3/3/12)	Ilow: 63 ± 8.6 Imed: 65 ± 6.6 Ihigh: 61 ± 6.2	3 to 4	abdomen	Ilow: 1 × 107 Imed: 5 × 107 Ihigh: 10 × 107	N/A	Injection Once	Cultured ADMSCs		No treatment-related adverse events	N/A	6
SVF
[29] China	RCT	6 (6/6) *6 patients /12 knees	I: 62.17 ± 6.34 C: 62.17 ± 6.34	1 to 2	abdomen	N/A	200–250	Injection Once	SVF	No treatment	No treatment-related adverse events	N/A	6
[30] Russia	Non-RCT	20 (10/10)	I: 52.5 [45.0;57.0] C: 56.5 [52.5;63.5] *median [interquartile range, 25th, 75th percentiles]	2 to 3	abdomen	N/A	150–200	Injection Once	Arthroscopic debridement HTO SVF	Arthroscopic debridement HTO PRP	Not reported	Not reported	18
[31] Russia	Non-RCT	26 (16/10)	I: 61 [57;64] C: 72 [60;77] *median [interquartile range, 25th, 75th percentiles]	2 to 3	abdomen	N/A	50	Injection Once	SVF	Hyaluronic acid	Discomfort Painless swelling Minor increase of temperature	Discomfort Painless swelling Minor increase of temperature	12
[32] (A) China	RCT	95 (47/48)	I: 50.83 ± 10.88 C: 52.87 ± 9.35	2 to 3	abdomen	N/A	100–150	Injection Once	SVF	Hyaluronic acid	Pain Swelling	Pain Swelling	12
[33] (B) China	RCT	126 (56/70)	I: 53.98 ± 13.69 C: 55.63 ± 12.18	2 to 3	abdomen	N/A	40	Injection Three times (once a month)	SVF	Hyaluronic acid	No treatment-related adverse events	No adverse events	60
[34] China	RCT	57 (29/28)	I: 52.27 ± 1.17 C: 51.77 ± 7.55	0 to 3	Infrapatellar fat pad	0.391 × 107	200	Injection Once	Arthroscopic debridement SVF	Arthroscopic debridement Saline	No treatment-related adverse events	No adverse events	12
[35] USA	RCT	39 (13/13/13)	Ilow: 60.5 ± 7.9 Ihigh: 59.5 ± 11.7 C: 57.1 ± 9.1	2 to 3	abdomen	N/A	75	Injection Once	SVF	Placebo (zero SVF cells)	Ilow No treatment-related adverse events Ihigh Swelling (1)	No adverse events	12
[36] Korea	Non-RCT (retrospective)	60 (30/30)	I: 63.0 ± 3.2 C: 63.2 ± 3.8	1 to 4	buttock	0.71 × 107	140	Injection Once	Arthrocentesis SVF	Arthrocentesis Hyaluronic acid	Swelling (2) Subcutaneous induration at the fat collection site (3)	Swelling (1)	12
[37] Taiwan	Non-RCT	33 (18/15)	I: 59 ± 6.04 C: 58.2 ± 5.7	2 to 3	abdomen	N/A	50–100	Injection Once	Arthroscopic microfracture SVF	Arthroscopic microfracture	Not reported	Not reported	24
[38] Korea	Non-RCT	100 (50/50)	I: 59.2 ± 4.5 C: 58.3 ± 5.6	3 to 4	buttock	0.426 × 107	N/A	Injection Once	Arthroscopic debridement HTO SVF	Arthroscopic debridement HTO	Not reported	Not reported	12
[39] Vietnam	Non-RCT	30 (15/15)	I: 58.6 ± 6.48 C: 58.2 ± 5.71	2 to 3	abdomen	N/A	100	Injection Once	Arthroscopic microfracture PRP SVF	Arthroscopic microfracture Saline	No treatment-related adverse events	No adverse events	18
[11] Korea	RCT	80 (40/40)	I: 38.4 ± 6.4 C: 39.1 ± 7.1	ICRS 3 to 4	buttock	0.497 × 107	N/A	Implantation Once	Arthroscopic debridement Arthroscopic microfracture SVF with fibrin glue scaffold	Arthroscopic debridement Arthroscopic microfracture	Not reported	Not reported	24
[40] Korea	RCT	44 (21/23)	I: 54.2 ± 2.9 C: 52.3 ± 4.9	1 to 3	buttock	0.411 × 107	140	Injection Once	Arthroscopic debridement HTO PRP SVF	Arthroscopic debridement HTO PRP	Not reported	Not reported	24
[41] Korea	Non-RCT	50 (25/25)	I: 54.2 ± 9.3 C: 54.4 ± 11.3	1 to 3	infrapatellar fat pad	0.189 × 107	9.4 g	Injection Once	Arthroscopic debridement PRP SVF	Arthroscopic debridement PRP	Pain and swelling (1) *The adverse effects are not specified as occurring in the intervention group or the control group		16.4 (12–18)
[42] China	RCT	16 (16/16) *16 patients /32 knees	Ileft: 53 ± 10.97 Iright: 51 ± 5.95 *reported based on the SVF-treated knee's side	2 to 3	abdomen	N/A	100–150	Injection Once	Arthroscopic debridement SVF	Arthroscopic debridement Hyaluronic acid	Muscle soreness at the fat collection site (4) Pain and swelling (6)	N/A	12
[43] Japan	Non-RCT	60 (30/30)	Ilow: 69.0 ± 8.3 Ihigh: 70.7 ± 5.3	2 to 4	abdomen	N/A	290–440	Injection Once	SVF		Ilow Pain and swelling (3) Ihigh Pain and swelling (2)	N/A	12
[45] Korea (A)	Non-RCT	40 (20/20)	Iimplantation : 59.1 ± 3.5 Iinjection : 59.4 ± 3.1	1 to 2	buttock	Iimplantation : 0.396 × 107 Iinjection: : 0.407 × 107	140	Implantation / Injection Once	Iimplantation: Arthroscopic debridement SVF with fibrin glue scaffold Iinjection: Arthroscopic debridement PRP SVF		Not reported	N/A	28
[45] Korea (B)	Non-RCT (retrospective)	54 (17/37)	Iwith : 57.7 ± 5.8 Iwithout : 57.5 ± 5.9	1 to 2	buttock	0.39 × 107	140	Implantation Once	Iwith: Arthroscopic debridement SVF with fibrin glue scaffold Iwithout: Arthroscopic debridement SVF without fibrin glue scaffold		No treatment-related adverse events	N/A	29.2

SD standard deviation K-L Grade Kellgren-Lawrence grade RCT randomized controlled trials N/A not available ADMSC Adipose-Derived Mesenchymal Stem Cell HTO Open-wedge High Tibial Osteotomy SVF Stromal Vascular Fracture PRP Platelet-Rich Plasma ICRS International Cartilage Repair Society

^**Booster injection for patients whose VAS had decreased by less than 50% from the pre-injection score