Adipose-derived and bone marrow aspirate concentrate injections for osteoarthritis: A scoping review.

This was a scoping review, not a pooled estimate of benefit, and the authors did not assess risk of bias, so studies of different quality were given equal weight. Most included studies were observational; only 19 of 84 studies were randomized controlled trials. Follow-up was often short, with only 30% of studies following patients for more than 1 year. The injections were not standardized: studies used different products, volumes, cell reporting, ultrasound guidance, and pre- or postprocedure protocols. The evidence was concentrated in the knee, with 75% of studies, so it says little about hip, shoulder, wrist, or hand osteoarthritis. Important patient factors were poorly reported: race and ethnicity were provided in only six studies, and BMI was reported in 30% of studies.

No funding was reported for the review. Leonardo Oliveira disclosed consulting with Trice Medical and Lipogems. Kenneth Mautner disclosed consulting with Lipogems.

Do not conclude that adipose or BMAC injections are better than PRP, saline, steroids, or exercise because 98% of studies reported change from baseline that reached statistical significance. Those were not controlled comparisons, and randomized trial results were mixed.