Comparison between Bone Marrow Aspirate Concentrate versus Stromal Vascular Fraction on Osteoarthritis Knee Patients: Meta-Analysis
Bibliographic record
Abstract
Background: Osteoarthritis (OA) of the knee is a leading cause of disability, with limited nonoperative treatment options that primarily focus on symptom relief rather than disease modification. Cell-based therapies, including bone marrow aspirate concentrate (BMAC) and stromal vascular fraction (SVF), have emerged as promising alternatives for managing knee OA. However, clinical evidence comparing their efficacy remains limited. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, Scopus, and Web of Science databases were searched for clinical studies reporting outcomes after a single intra-articular injection of autologous BMAC or SVF in patients with varying degrees of knee OA. Studies involving adjunct procedures, culture-expanded cells, or multiple injections were excluded. Pain reduction, assessed by the Visual Analog Scale (VAS), and functional improvement, measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), were the primary outcomes. Standardized mean difference (SMD) with 95% confidence intervals (CI) was calculated using a random-effects model. Results: Six studies comprising 261 patients (111 BMAC, 150 SVF) were included. Both treatments resulted in significant improvement in pain and function. BMAC reduced mean VAS from 4.5 ± 1.27 to 1.71 ± 0.82 (SMD 2.609; 95% CI, 1.781–3.436), while SVF reduced VAS from 6.1 ± 1.1 to 3.3 ± 1.5 (SMD 3.470; 95% CI, 1.175–5.765). SVF showed significantly greater pain reduction compared with BMAC (P < 0.0001). Both BMAC (SMD 1.403; 95% CI, 0.385–2.421) and SVF (SMD 1.125; 95% CI, 0.497–1.754) demonstrated equivalent functional improvement according to WOMAC scores (P = 0.626). Study heterogeneity and methodological inconsistencies were noted, particularly in cell preparation and reporting standards. Conclusion: A single injection of either BMAC or SVF provides short-term symptomatic relief in knee OA. SVF appears superior to BMAC for pain reduction, while both are equally effective in improving function. Given the heterogeneity of preparation protocols and limited high-quality evidence, results should be interpreted with caution. Further standardized, large-scale randomized controlled trials are needed to establish definitive recommendations. Keywords: Knee osteoarthritis; Bone marrow aspirate concentrate; Stromal vascular fraction; Cell-based therapy
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.021 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.023 | 0.061 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".