Clinical Efficacy of Bone Marrow Aspirate Concentrate Versus Stromal Vascular Fraction Injection in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652110145
Author(s):  
Ioanna K. Bolia ◽  
Sofia Bougioukli ◽  
William J. Hill ◽  
Nicholas A. Trasolini ◽  
Frank A. Petrigliano ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Clinical Efficacy ◽  
Bone Marrow Aspirate ◽  
Meta Analysis ◽  
Stromal Vascular Fraction ◽  
Symptomatic Improvement ◽  
Knee Oa

Background: Knee injection using either bone marrow aspirate concentrate (BMAC) or stromal vascular fraction (SVF) from adipose tissue has been shown to result in symptomatic improvement in patients with knee osteoarthritis (OA). It is still unclear whether one of these therapies is superior over the other. Purpose: To systematically report the clinical studies evaluating BMAC and SVF in the treatment of knee OA and to compare the clinical efficacy of these 2 injection therapies. Study Design: Meta-analysis; Level of evidence, 4. Methods: This meta-analysis was performed per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Studies were included if they reported the clinical outcomes after a single BMAC or SVF injection in the knee joint of patients with OA. Studies evaluating preparations of culture-expanded stem cells were excluded. A random effects model was used; the clinical efficacy of BMAC or SVF injection was assessed using the standardized mean difference (SMD) and compared. Visual analog scale (VAS) scores for pain and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) knee index were the primary outcomes. The level of statistical significance was set at P < .05. Results: Ten studies and 472 patients with knee OA who received either BMAC (233 patients) or SVF (239 patients) were included. Patients who received an injection had improved VAS outcomes (mean ± SD): from 5.8 ± 1.3 to 2.6 ± 17 for BMAC and from 6.4 ± 1.4 to 3.4 ± 0.5 for SVF. They also experienced significantly reduced pain (SMD [VAS], 2.6 for BMAC and 3.4 for SVF) and improved function (SMD [WOMAC], 1.4 for BMAC and 1.2 for SVF). However, the SVF injection had a significantly greater effect on pain reduction than did the BMAC injection ( P < .0001). Based on WOMAC, the clinical effect of BMAC versus SVF knee injection in patients with knee OA was equivalent ( P = .626). Results were limited by the presence of publication bias as well as variability in the preparation methods utilized in the BMAC and SVF injection protocols. Complications were reported in 50% of the BMAC studies (knee stiffness, persistent knee swelling) and 67% of the SVF studies (knee swelling, knee pain, positive SVF cultures without symptoms of infection, and bleeding at the abdominal harvest site). Conclusion: A single BMAC or SVF injection into the knee joint of patients with OA resulted in symptomatic improvement at short-term follow-up. However, SVF seemed to be more effective than did BMAC in the reduction of knee pain. There was significant variation in the BMAC and SVF injection preparation techniques used across the studies and a lack of stratification of outcomes based on the radiologic classification of OA. Therefore, these results should be taken with caution.

scholarly journals BMAC and Adipose-Derived MSCs Treatment for Knee Osteoarthritis: A Systematic Review

2021 ◽  
Vol 7 (04) ◽  
pp. 01-11
Author(s):  
Pooja Pithadia
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Stromal Vascular Fraction ◽  
Cochrane Library ◽  
Bone Marrow Aspirate Concentrate ◽  
Mesh Terms

Background: Knee osteoarthritis is the most common musculoskeletal progressive disorder that affects nearly 303 million people worldwide. This condition prevails in 10% males and 13% females among the elders above 60. Although there is conventional nonsurgical and surgical treatment available for knee osteoarthritis, there is a fascinating interest in bone marrow aspirate concentrate (BMAC) as well as adipose-derived mesenchymal stem cells (AD-MSC), including enzymatically treated stromal vascular fraction (SVF) and mechanically treated (microfat/nanofat) injections among physicians. Hence, this systematic review aims to determine the efficacy of BMAC and AD-MSCs (enzyme and mechanically treated) injections for knee osteoarthritis treatment. Methods: A systematic review was performed on the following data sources (PubMed, Scopus, Google Scholar, EMBASE, and Cochrane Library) published on March 31, 2021. The keywords or MeSH terms include 'Knee Osteoarthritis with 'Bone marrow aspirate concentrate' OR 'BMAC' or with 'Adipose-derived mesenchymal stem cells (AD-MSC)' or with 'Stromal vascular fraction' OR 'SVF' or 'Mechanically treated AD-MSC (mfat/nanofat)'. In addition, the retrieved articles were further reviewed to identify relevant research studies. Results: The authors reviewed and tabulated data based on the year of study, study type, therapy protocol, patient population, outcome measures, and interpretation. Among the 382 records screened, 43 studies (16 on BMAC and 27 on AD-MSCs) were included in the systematic review study. Among them, only 5 were randomized controlled trials. These selected studies demonstrated short-term positive outcomes such as improvement in knee pain and function with no adverse side effects. Moreover, researchers reported varied administration methods of BMAC or AD-MSC either as standalone or in combination with other conservative procedures such as PRP (Platelets Rich Plasma), HA (Hyaluronic acid), or surgery. Conclusions: BMAC and AD-MSC (enzymatically and mechanically treated) injections prove safer and more efficacious in patients with knee osteoarthritis for a shorter duration of 2 years. However, the available literature lacks high-quality studies with no varied clinical settings and long-term follow-up of more than two years.

scholarly journals Association of subchondral bone marrow lesion localisation with weight bearing pain in people with knee osteoarthritis: data from the Osteoarthritis Initiative

2021 ◽  
Author(s):  
Koji Aso ◽  
Seyed Mohsen Shahtaheri ◽  
Daniel F. McWilliams ◽  
David A. Walsh
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Subchondral Bone ◽  
Negative Binomial ◽  
Weight Bearing ◽  
The Other ◽  
Knee Oa ◽  
Pain Scores ◽  
Osteoarthritis Initiative

Abstract Background Subchondral bone marrow lesions (BMLs) detected on MRI in knee osteoarthritis (OA) are associated with knee pain. The prevalence and progression of subchondral BMLs are increased by mechanical knee load. However, associations of subchondral BML location with weight-bearing knee pain are currently unknown. In this study, we aim to demonstrate associations of subchondral BML location and size with weight-bearing knee pain in knee OA.Methods We analyzed 1412 and 582 varus knees from cross-sectional and longitudinal Osteoarthritis Initiative datasets, respectively. BML scores were semi-quantitatively analysed with the MRI Osteoarthritis Knee Score for 4 subchondral regions (median and lateral femorotibial, medial and lateral patellofemoral) and subspinous region. Weight-bearing and non-weight-bearing pain scores were derived from WOMAC pain items. Correlation and negative binomial regression models were used for analysis of associations between the BML scores and pain at baseline, and changes in the BML scores and changes in pain after 24-month follow up.Results Greater BML scores at medial femorotibial and lateral patellofemoral compartments were associated with greater weight-bearing pain scores, and statistical significance was retained after adjusting for BML scores at the other 4 joint compartments and other OA features, as well as for non-weight-bearing pain, age, sex and Body Mass Index (BMI) (medial femorotibial; B=0.08, p=0.02. patellofemoral; B=0.13, p=0.01). Subanalysis revealed that greater medial femorotibial BML scores were associated with greater pain on walking and standing (B=0.11, p=0.01, and B=0.10, p=0.04, respectively). Lateral patellofemoral BML scores were associated with pain on climbing, respectively B=0.14, p=0.02. Increases or decreases over 24 months in BML score in the medial femorotibial compartment were significantly associated with increases or decreases in weight-bearing pain severity after adjusting for non-weight-bearing pain, age, sex, baseline weight-bearing pain, BMI, and BML at the other 4 joint compartments (B=0.10, p=0.01). Conclusions Subchondral BML size at the medial femorotibial joint compartment was specifically associated with the severity and the change in weight-bearing pain, independent of non-weight-bearing pain, in knee OA. Specific associations of weight-bearing pain with subchondral BMLs in weight-bearing compartments of the knee indicate that BMLs in subchondral bone contribute to biomechanically-induced OA pain.

The Stem-Cell Market for the Treatment of Knee Osteoarthritis: A Patient Perspective

2017 ◽  
Vol 31 (06) ◽  
pp. 551-556 ◽  
Author(s):  
Nicolas Piuzzi ◽  
Mitchell Ng ◽  
Morad Chughtai ◽  
Anton Khlopas ◽  
Kenneth Ng ◽  
...  
Keyword(s):  
Stem Cell ◽  
Standard Deviation ◽  
Knee Osteoarthritis ◽  
Clinical Efficacy ◽  
Symptomatic Improvement ◽  
Stem Cell Therapies ◽  
Cell Therapies ◽  
Musculoskeletal Conditions ◽  
Knee Oa ◽  
The Mean

AbstractThe use of stem-cell therapies for the treatment of various musculoskeletal conditions, especially knee osteoarthritis (OA), is rapidly expanding, despite only low-level evidence to support its use. Centers offering these therapies are often marketing and charging patients out-of-pocket costs for such services. Therefore, the purpose of this study was to determine the current marketed: (1) prices and (2) clinical efficacy of stem-cell therapies for knee OA. This was a prospective cross-sectional study which queried 317 U.S. centers that offered direct-to-consumer stem-cell therapies for musculoskeletal conditions. A total of 273 of 317 centers were successfully contacted via phone or e-mail, using a simulated 57-year-old male patient with knee OA. Scripted questions were asked by the simulated patient to determine the marketed prices and clinical efficacy. Centers generally reported the proportion of patients who had “good results” or “symptomatic improvement.” The mean price of a unilateral (same-day) stem-cell knee injection was $5,156 with a standard deviation of $2,446 (95% confidence interval [CI]: $4,550–5,762, n = 65). The mean proportion of claimed clinical efficacy was 82% with a standard deviation of 9.6% (95% CI: 79.0–85.5%, n = 36). Most American stem-cell centers offer therapies for knee OA. The cost of these therapies averages about $5,000 per injection, and centers claim that 80% of the patients had “good results” or “symptomatic improvement,” denoting a gap between what is documented in the published literature and the marketing claims. These findings offer both patients and physicians insight into the current stem-cell market for knee OA. We hope that with this information, providers can more optimally make patients aware of discrepancies between what is being marketed versus the current evidence-based landscape of these therapies for knee OA.

scholarly journals Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial

2020 ◽  
Vol 8 (2) ◽  
pp. 232596711990095 ◽  
Author(s):  
Adam W. Anz ◽  
Ryan Hubbard ◽  
Nicole K. Rendos ◽  
Peter A. Everts ◽  
James R. Andrews ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Clinical Evidence ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
The United States ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Symptomatic Knee

Background: Approximately 47 million people in the United States have been diagnosed with arthritis. Autologous platelet-rich plasma (PRP) injections have been documented to alleviate symptoms related to knee osteoarthritis (OA) in randomized controlled trials, systematic reviews, and meta-analyses. Autologous bone marrow aspirate concentrate (BMC) injections have also emerged as a treatment option for knee OA, with a limited clinical evidence base. Purpose: To compare the efficacy of BMC to PRP for the treatment of knee OA regarding pain and function at multiple time points up to 12 months after an injection. We hypothesized that BMC will be more effective in improving outcomes in patients with knee OA. Study Design: Randomized controlled trial; Level of evidence, 2 Methods: A total of 90 participants aged between 18 and 80 years with symptomatic knee OA (Kellgren-Lawrence grades 1-3) were randomized into 2 study groups: PRP and BMC. Both groups completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subjective International Knee Documentation Committee (IKDC) questionnaires before and 1, 3, 6, 9, and 12 months after a single intra-articular injection of leukocyte-rich PRP or BMC. Results: There were no statistically significant differences in baseline IKDC or WOMAC scores between the 2 groups. All IKDC and WOMAC scores for both the PRP and BMC groups significantly improved from baseline to 1 month after the injection ( P < .001). These improvements were sustained for 12 months after the injection, with no difference between PRP and BMC at any time point. Conclusion: Both PRP and BMC were effective in improving patient-reported outcomes in patients with mild to moderate knee OA for at least 12 months; neither treatment provided a superior clinical benefit. Autologous PRP and BMC showed promising clinical potential as therapeutic agents for the treatment of OA, and while PRP has strong clinical evidence to support its efficacy, BMC has limited support. This study did not prove BMC to be superior to PRP, providing guidance to clinicians treating OA. It is possible that the results were affected by patients knowing that there was no control group. Registration: NCT03289416 ( ClinicalTrials.gov identifier).

Bone Marrow Aspirate Concentrate for the Treatment of Knee Osteoarthritis: A Systematic Review

2021 ◽  
pp. 036354652110188
Author(s):  
Laura E. Keeling ◽  
John W. Belk ◽  
Matthew J. Kraeutler ◽  
Alexandra C. Kallner ◽  
Adam Lindsay ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Patient Reported Outcomes ◽  
Bone Marrow Aspirate ◽  
Cochrane Library ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Patient Reported

Background: Bone marrow aspirate concentrate (BMAC) has emerged as a therapeutic option for symptomatic knee osteoarthritis (OA). Purpose: To systematically review the literature to evaluate the efficacy of isolated BMAC injection in the treatment of OA of the knee joint. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed by searching the PubMed, Embase, and Cochrane Library databases up to July 2020 to identify human studies that assessed the clinical outcomes of isolated BMAC injection for the treatment of knee OA. The electronic search strategy used was “bone marrow aspirate concentrate knee osteoarthritis.” Results: Eight studies met the inclusion criteria, including a total of 299 knees with a mean follow-up of 12.9 months (range, 6-30 months). Of all patient-reported outcomes assessed across studies, 34 of 36 (94.4%) demonstrated significant improvement from baseline to latest follow-up ( P < .05). Five studies evaluating numerical pain scores (visual analog scale and Numeric Rating Scale) reported significant improvements in pain level at final follow-up ( P < .01). However, 3 comparative studies evaluating BMAC in relation to other therapeutic injections failed to demonstrate the clinical superiority of BMAC. Conclusion: The BMAC injection is effective in improving pain and patient-reported outcomes in patients with knee OA at short- to midterm follow-up. Nevertheless, BMAC has not demonstrated clinical superiority in relation to other biologic therapies commonly used in the treatment of OA, including platelet-rich plasma and microfragmented adipose tissue, or in relation to placebo. The high cost of the BMAC injection in comparison with other biologic and nonoperative treatment modalities may limit its utility despite demonstrable clinical benefit.

scholarly journals Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

2021 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Matsumoto ◽  
Satoshi Sobajima ◽  
Takehiko Matsushita ◽  
Hideki Iwaguro ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Dose Group ◽  
Stromal Vascular Fraction ◽  
Cartilage Defects ◽  
High Dose ◽  
Short Term ◽  
Bone Marrow Lesions ◽  
Knee Oa ◽  
Different Doses

Abstract Background: Favorable clinical outcomes of the intra-articular injection of adipose-derived stromal vascular fraction (SVF) cells for knee osteoarthritis (OA) have been reported. This study aimed to compare the short-term clinical and imaging outcomes of different doses of SVF cells for knee OA treatment.Methods: This study included 60 patients with knee OA who underwent intra-articular injection of SVF cells. The follow-up period was at least 12 months. The envelope method was used to prospectively quasi-randomized the patients to undergo treatment with different doses of SVF cells. Thirty patients received an intra-articular injection of 2.5×107 SVF cells (low-dose group), and the remaining 30 patients received an intra-articular injection of 5.0×107 SVF cells (high-dose group). Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the hip-knee-ankle angle and magnetic resonance imaging Osteoarthritis Knee Score (MOAKS) features (bone marrow lesions, cartilage defects, osteophytes, Hoffa’s synovitis, and effusion synovitis), were also performed. All clinical and imaging evaluations were performed preoperatively and 12 months postoperatively and compared between the groups.Results: No significant differences in demographic data were found between the two groups. The knee extension angle at 12 months postoperatively was significantly higher than the preoperative angle in both groups. The total WOMAC and VAS scores at 12 months postoperatively were significantly more favorable than preoperative scores in both groups. The bone marrow lesions and Hoffa’s synovitis and effusion synovitis improved approximately 30-40% from baseline to 12 months postoperatively in both groups. However, there were no significant differences in the preoperative and postoperative results of any clinical or imaging evaluation between the two groups.Conclusions: The short-term clinical and imaging outcomes of intra-articular injection of SVF cells for knee OA were excellent, regardless of whether a low- or high-dose was administered. Intra-articular injection of SVF cells for knee OA is an innovative approach.

scholarly journals Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1193
Author(s):  
Oliver Dulic ◽  
Predrag Rasovic ◽  
Ivica Lalic ◽  
Vaso Kecojevic ◽  
Gordan Gavrilovic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hyaluronic Acid ◽  
Side Effects ◽  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Bone Marrow Aspirate Concentrate ◽  
Knee Oa ◽  
Grade Ii

Background: In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare clinical outcomes of knee injections of Bone Marrow Aspirate Concentrate (BMAC), Platelet-rich Plasma (PRP), or Hyaluronic acid (HA) in the OA treatment. Methods: Patients with knee pain and osteoarthritis KL grade II to IV were randomized to receive a BMAC, PRP, and HA injection in the knee. VAS, WOMAC, KOOS, and IKDC scores were used to establish baseline values at 1, 3, 6, 9, and 12 months. All side effects were reported. Results: A total of 175 patients with a knee osteoarthritis KL grade II-IV were randomized; 111 were treated with BMAC injection, 30 with HA injection, and 34 patients with PRP injection. There were no differences between these groups when considering KL grade, BMI, age, or gender. There were no serious side effects. The mean VAS scores after 3, 7, 14, and 21 days showed significant differences between groups with a drop of VAS in all groups but with a difference in the BMAC group in comparison to other groups (p < 0.001). There were high statistically significant differences between baseline scores and those after 12 months (p < 0.001) in WOMAC, KOOS, KOOS pain, and IKDC scores, and in addition, there were differences between these scores in the BMAC group in comparison with other groups, except for the PRP group in WOMAC and the partial IKDC score. There were no differences between the HA and PRP groups, although PRP showed a higher level of clinical improvement. Conclusions: Bone marrow aspirate concentrate, Leukocyte rich Platelet Rich Plasma, and Hyaluronic acid injections are safe therapeutic options for knee OA and provide positive clinical outcomes after 12 months in comparison with findings preceding the intervention. BMAC could be better in terms of clinical improvements in the treatment of knee OA than PRP and HA up to 12 months. PRP provides better outcomes than HA during the observation period, but these results are not statistically significant. More randomized controlled trials and high quality comparative studies are needed for direct correlative conclusions.

scholarly journals Minimally Manipulated Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis: A Systematic Review of Clinical Evidence

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
B. Di Matteo ◽  
F. Vandenbulcke ◽  
N. D. Vitale ◽  
F. Iacono ◽  
K. Ashmore ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Stromal Vascular Fraction ◽  
Short Term ◽  
Keywords Knee ◽  
Mesh Terms

Background. The use of laboratory-expanded mesenchymal stem cells (MSCs) is subject to several restrictions, resulting in “minimal manipulation” methods becoming the current most popular strategy to increase the use of MSCs in an orthopaedic practice. The aim of the present systematic review is to assess the clinical applications of “minimally” manipulated MSCs, either as bone marrow aspirate concentrate (BMAC) or as stromal vascular fraction (SVF), in the treatment of knee osteoarthritis (OA). Methods. A systematic review of three databases (PubMed, ScienceDirect, and Google Scholar) was performed using the following keywords: “Knee Osteoarthritis” with “(Bone marrow aspirate) OR (bone marrow concentrate)” or with “(adipose-derived mesenchymal stem cells) OR (adipose derived stromal cells) OR (stromal vascular fraction) OR (SVF)” as either keywords or MeSH terms. The reference lists of all retrieved articles were further reviewed for identification of potentially relevant studies. Results. Twenty-three papers were included in the final analysis (10 on BMAC and 13 on SVF). Of these, only 4 were randomized controlled trials (RCTs). Bias risk evaluation, performed using a modified Coleman score, revealed an overall poor quality of the studies. In terms of clinical application, despite the apparent safety of minimally manipulated MSCs and the short-term positive clinical outcomes associated with their use, clinicians reported different preparation and administration methods, ranging from single intra-articular injections to intraosseous applications to administration in combination with other surgical procedures. Conclusions. The available literature is undermined by both the lack of high-quality studies and the varied clinical settings and different protocols reported in the few RCTs presently published. This prevents any recommendation on the use of either product in a clinical practice. Nevertheless, the use of minimally manipulated MSCs (in the form of BMAC or SVF) has been shown to be safe and have some short-term beneficial effects.

scholarly journals Efficacy and safety of radiofrequency treatment for improving knee pain and function in knee osteoarthritis: a meta-analysis of randomized controlled trials

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jian Liu ◽  
Ting Wang ◽  
Zhen-Hua Zhu
Keyword(s):  
Adverse Effects ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Knee Pain ◽  
Meta Analysis ◽  
Knee Function ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Knee Oa ◽  
Randomized Controlled

Abstract Background The clinical utility of radiofrequency (RF) in patients with knee osteoarthritis (OA) remains unclear. We conducted a meta-analysis to systematically evaluate the efficacy and safety of RF treatment in patients with knee OA. Methods Searches of the PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases were performed through August 30, 2021. The major outcomes from published randomized controlled trials (RCTs) involving patients with knee OA were compared between RF and control groups, including Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Global Perceived Effect (GPE) scale, and adverse effects at available follow-up times. Results Fifteen RCTs involving 1009 patients were included in this meta-analysis, and the results demonstrated that RF treatment correlated with improvements in pain relief (VAS/NRS score, all P < 0.001) and knee function (WOMAC, all P < 0.001) at 1–2, 4, 12, and 24 weeks after treatment as well as patients’ degree of satisfaction with treatment effectiveness (GPE scale, 12 weeks, P < 0.001). OKSs did not differ significantly between the two groups. Moreover, treatment with RF did not significantly increase adverse effects. Subgroup analysis of knee pain indicated that the efficacy of RF treatment targeting the genicular nerve was significantly better than intra-articular RF at 12 weeks after treatment (P = 0.03). Conclusions This meta-analysis showed that RF is an efficacious and safe treatment for relieving knee pain and improving knee function in patients with knee OA.

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