Osteoarthritis Magna Cum Laude

P-10.3.4 - MF-AT versus PRP for the Treatment of Knee Osteoarthritis: A Prospective RCT at 2-year Follow-up

Abstract

Purpose

No high-level studies investigated the potential of micro-fragmented adipose tissue (MF-AT) over other biological products like platelet-rich plasma (PRP). The aim of this randomized controlled trial (RCT) was to compare a single injection of MF-AT to PRP in terms of clinical outcome and disease-modifying properties in patients with symptomatic knee OA.

Methods and Materials

A total of 118 knee OA patients were randomly assigned to a single intra-articular MF-AT vs PRP injection and evaluated before the injection and at 1-3-6-12- 24 months with the IKDC subjective score, KOOS subscales, EQ-VAS, EQ-5D, and VAS pain. The treated knees were also evaluated at baseline and at 6-12-24 months of follow-up with radiographs and high-resolution MRI with the WORMS.

Results

Both MF-AT and PRP provided a statistically significant improvement up to the last follow-up of 24 months. No differences were found between MF-AT and PRP groups in terms of adverse events (18.9%vs10.9%), failures (15.1%vs25.5%), and all clinical outcomes at all follow-ups. Radiographs and MRI findings did not show significant changes after the injection, neither as improvement, nor as disease progression, with no intergroup difference. Patients with moderate/severe OA treated with MF-AT showed a significantly higher IKDC improvement at 6 months compared to PRP (15.7±19.0 vs 8.6±14.2, p=0.041). Similarly, more patients with moderate/severe OA treated with MF-AT reached the MCID for the IKDC subjective score at 6 months compared to the PRP group (75.0%vs34.6%, p=0.005).

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Conclusion

A single intra-articular injection of both MF-AT and PRP provided a significant clinical improvement up to 24 months in patients with symptomatic knee OA. Both treatments showed a comparable low number of failures and adverse events, without signs of disease progression. Overall, no differences could be documented in both clinical and imaging results between the two biological approaches. Compared with PRP, MF-AT provided a higher clinical improvement at 6 months in moderate-severe OA.
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