Efficacy of Bone Marrow Aspirate Concentrate Versus Platelet-rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
In knee osteoarthritis (KOA), intra-articular bone marrow aspirate concentrate (IA-BMAC) and platelet-rich plasma (IA-PRP) are widely studied orthobiologic therapies, yet comparative evidence regarding their efficacy remains inconsistent. A meta-analysis was conducted to compare the efficacy and safety of IA-BMAC versus IA-PRP in KOA. PubMed, Cochrane Library, and Google Scholar were searched up to May 2025. Two randomized controlled trials and one comparative retrospective study involving 186 patients treated with IA-BMAC and 88 with IA-PRP were included. The primary outcome was change in pain score, while secondary outcomes included changes in the International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Pooled mean differences with 95% confidence intervals were calculated. Both IA-BMAC and IA-PRP demonstrated comparable reductions in pain and WOMAC scores at 1, 3, 6, 9, and 12 months ( P > 0.05), although heterogeneity was significant. IA-BMAC resulted in significantly greater improvements in IKDC at 3 months (MD = 6.88, 95% CI = 3.14–10.62; P < 0.001), 6 months (MD = 4.13, 95% CI = 0.01–8.25; P = 0.04), and 12 months (MD = 4.48, 95% CI = 0.23–8.74; P = 0.03), with no significant difference at 1 and 9 months. KOOS improvement favored IA-BMAC at 1 month (MD = 7.10, 95% CI = 2.47–11.72; P = 0.002) but not at later time points. Sensitivity analysis excluding the retrospective study reduced heterogeneity and revealed significantly greater WOMAC improvement with IA-BMAC at 3 months (MD = −4.81, 95% CI = −8.75 to −0.86; P = 0.01). Both IA-BMAC and IA-PRP are effective in KOA, with IA-BMAC demonstrating modest functional advantages. Larger, high-quality randomized trials are required to confirm these findings.
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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 | 0.010 | 0.019 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.022 | 0.034 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".