Clinical efficacy of cell-free fat extract and its effects on bone marrow edema in patients with early to mid-stage knee osteoarthritis: a clinical trial in comparison with hyaluronic acid.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(10):29 J Orthop Surg Res . 2025 Feb 9;20(1):153.What this means for my practice?
The key takeaway is that intra-articular injection of CEFFE was more effective than HA in improving clinical symptoms and reducing subchondral bone marrow edema in early to mid-stage knee osteoarthritis over 6 months. These findings suggest that CEFFE might offer a promising therapeutic option for long-term management of knee osteoarthritis. However, limitations include a relatively small sample size, short follow-up duration, and methodological variations in CEFFE preparation.
Study Summary
Forty-six patients with early to mid-stage knee osteoarthritis were randomized to receive either intra-articular Cell-Free Fat Extract (CEFFE) (n=26) or hyaluronic acid (HA) (n=26). Each group received five weekly injections of 2 ml. The primary outcome was clinical efficacy measured at 6 months, including VAS, WOMAC, and Lysholm scores. Secondary outcomes included MRI-based bone marrow edema grading at 6 months. Overall, the results revealed that both treatments significantly improved clinical symptoms and reduced bone marrow edema, but CEFFE demonstrated superior improvement in all measures at 6 months (P<0.05). These findings suggest that CEFFE may offer longer-lasting clinical improvement and better subchondral bone marrow edema reduction than HA.
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