Publication Study design Disease Therapeutic protocol Outcome Patient characteristic F-up Main findings Hernigou et al. [25 ] RCT (TKA on contralateral knee) Bilateral OA secondary to severe ON related to corticosteroids BMAC graft percutaneously injected to the subchondrium of the femur and tibia vs. TKA on contralateral knee MRI, radiographs, bone marrow lesion volume, Knee society score 30 (30 BMAC, 30 TKA)Age: 18-41Sex: M-F: 12-18K-L: IV 8-16 years (mean: 12) Decrease in ON size by 40%. Cartilage and bone repair observed. Outcome was not statistically significantly different between BMAC and TKA. The majority of patients preferred BMAC. Themistocleous et al. [16 ] Retrospective OA BMAC injection alone NPS and OKS 121Age: 70 (50-85)Sex: M-F: 36-85K-L: III-IV 11 months (range 6-30) Significant improvement of both knee pain and function. Shaw et al. [17 ] Retrospective OA 4 sequential BMAC injections in 3 months Resting/active NPS, overall percentage improvement and LEFS 15 (20 knees)Age: 67.7 (7.9)Sex: M-F: 5-10K-L: N/A 24 days from last injection Significant improvement of both knee pain and function. The additional benefit with each subsequent treatment may suggest that multiple injections are more effective than a single one. Rodriguez-Fontan et al. [18 ] Retrospective OA 12 ml BMAC injection alone WOMAC 19: 10 knees and 15 hipsAge: mean 58 (30-80)Sex: M-F: 3-16K-L: I-II 6-24 months Significantly improved WOMAC score; no significant difference between six-month and latest follow-up scores. Variable satisfaction rate (63.2% yes, 36.8% no). Shapiro et al. [19 ] Single-blind RCT (placebo on contralateral knee) Bilateral OA BMAC+platelet-poor plasma (PRP) vs. saline injection VAS, ICOAP, and algometer 25 (25 vs. 25 knees)Age: median 60 (42-68)Sex: M-F: 7-18K-L: I-III 12 months Significant improvement in pain and quality of life. No superiority to saline injection. No evidence for cartilage regeneration on MRI (T2 mapping). Sampson et al. [20 ] Retrospective OA BMAC injection followed by a PRP booster injection at approximately 8 weeks VAS and global patient satisfaction 73 (100 knees)Age: range 23-79Sex: N/AK-L: III-IV 5 months Significant improvement of knee pain. High level of patient satisfaction. Vad et al. [24 ] Pilot trial OA Injection of tibial BMAC to the femoral and tibial chondral-bone interface and intra-articular knee joint space via the PeCaBoo delivery system MRI, WOMAC, participant-reportednumeric pain rating scale 10Age: 63.5 (52-73)Sex: M-L: 4-6K-L: III-IV 13-15 months (mean: 14) Significant improvement in WOMAC and NRS scores. MRI displayed an increase in extracellular matrix thickness by an average of 14%. Improvements were more substantial for patients younger than 63.5 years old. Centeno et al. [21 ] Comparative retrospective (registry data) OA (A) NPS, LEFS, IKDC, improvement rating score 373 (424 knees): (224 vs. 185)Age: 54.5 vs. 50.2Sex: M-F:143-81/140-45K-L: I-IV 3-15 months Significant improvement of both knee pain and function. Significantly higher pain reduction in patients treated with BMAC with high cell content. Centeno et al. [22 ] Comparative retrospective (registry data) OA (A) BMAC+PRP vs. (B) BMAC+PRP+adipose tissue NPS, LEFS, improvement rating score 681 (840 knees): (616 vs. 224)Age: 54.3 vs. 59.9Sex: M-F: 397 : 219/119 : 105K-L: I-IV 6-10 months Significant improvement of both knee pain and function. No detectible benefit with the addition of an adipose graft to the BMAC. Kim et al. [23 ] Retrospective OA BMAC+adipose tissue inj.+arthroscopic debridement (6), microfractures (5), and HTO (1) VAS, IKDC, SF-36, KOOS, Lysholm 41 (75 knees)Age: 60.7 (53–80)Sex: M-F: 17-24K-L: I-IV 8.7 months Significant improvement of both knee pain and function. Better outcomes in early to moderate phases.
