Table 2.
Summary of features and results of clinical studies applying BMAC for knee OA treatment
| References | Cell donor | Patients | Study design | Study results | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of patients | Knee OA grading | Age range | Type of study (ClinicalTrials.gov Identifier if applies) | Experimental group(s) | Cell dosage | Treatment comparator | Follow-up | Measurements | Main outcomes | ||
| Kim [30] | Autologous | 41 (75 knees) | KL I–IV | 53–80 years | N/A | BMAC injected in combination with adipose tissue | N/A | – | 12 months |
VAS International knee documentation committee scale SF-36 quality-of-life questionnaire Knee injury and OA outcome score Lysholm score |
↓ Pain ↑ Knee function Poorer outcomes in patients with KL IV compared to patients with OA at an earlier stage |
| Centeno [31] | Autologous | 681 (840 knees) | KL I–IV |
N/A Mean age reported for the two groups 54.3 years 59.9 years |
Report based on registry data |
BMAC injected in combination with PRP BMAC injected in combination with adipose graft and PRP |
N/A | – | 12 months |
Numeric pain scale Lower extremity functional scale Improvement rating score |
↓ Pain ↑ Knee function No difference between BMAC injection with and without adipose graft |
| Centeno [32] | Autologous | 373 (424 knees) | KL I–IV |
N/A Mean age reported for the two groups 54.5 years 50.2 years |
Report based on registry data |
BMAC with low cell content combined with PRP and platelet lysate BMAC with high cell content combined with PRP and platelet lysate |
-> 4 × 108 cells -≤ 4 × 108 cells |
– | 12 months |
Numeric pain scale Lower extremity functional scale International knee documentation committee scale Improvement rating score |
↓ Pain ↑ Knee function Significantly higher pain reduction in patients treated with BMAC with high mononuclear cell content |
| Sampson [33] | Autologous |
27 (bilateral knee OA) 46 (unilateral knee OA) |
KL III–IV | 23–79 years | Retrospective case series | BMAC injection followed by PRP injection (8 weeks later) | N/A | – | 5 months |
VAS Global patient satisfaction survey |
↓ Pain High levels of patient satisfaction |
| Shapiro [34] | Autologous | 25 (bilateral knee OA) | KL I–III | 42–68 years |
Prospective, randomized single-blind, placebo-controlled trial (NCT01931007) |
Injection of BMAC combined with platelet-poor plasma | N/A | Placebo (contralateral knee) | 6 months |
VAS Intermittent and constant OA pain questionnaire |
↓ Pain No significant difference in pain relief between knees treated with BMAC and with saline solution |