{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:01:04Z","timestamp":1790434864594,"version":"4.1.0"},"reference-count":58,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the comparative effectiveness of intra\u2010articular platelet\u2010rich plasma (PRP), stromal vascular fraction (SVF), bone marrow aspirate concentrate (BMAC), umbilical cord\u2010derived mesenchymal stem cell (UC\u2010MSC), and hyaluronic acid (HA) for pain relief and functional improvement in patients with knee osteoarthritis through network meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted using major biomedical databases to identify randomized controlled trials that compared the clinical efficacies of PRP, SVF, BMAC, UC\u2010MSC, and HA. The clinical scores for pain and function were standardized for network meta\u2010analysis based on minimal clinically important differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010four studies, with 2960 patients, were included. SVF and BMAC showed significantly greater reductions in pain scores than HA at 3, 6, and 12\u2009months (mean difference [MD], \u22120.7 to \u22121.1), whereas UC\u2010MSC and PRP showed modest or nonsignificant effects (MD, \u22120.3 to \u22120.7). Functional outcomes showed a similar trend, with SVF and BMAC producing the greatest improvements (MD, \u22120.6 to \u22121.4), followed by UC\u2010MSC and PRP (MD, \u22120.3 to \u22120.9). However, the magnitude of change in both pain and function did not exceed the minimal clinically important difference. At the final follow\u2010up, SVF had the highest surface under the cumulative ranking curve, followed by BMAC and UC\u2010MSC, with PRP ranking lower and HA showing the lowest value. The radiologic findings suggested potential cartilage repair benefits for orthobiologics; however, the results were inconsistent. No serious adverse events were reported, although procedure\u2010specific complications were observed in some interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The improvements in pain and functional outcomes achieved by orthobiologic injections, including SVF, BMAC, UC\u2010MSC, and PRP, did not exceed the minimal clinically important difference when compared with HA for knee osteoarthritis up to 12\u2009months postinjection. Although some treatments showed statistically significant differences, these changes did not translate into clinically meaningful benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I, network meta\u2010analysis of randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70411","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:18:22Z","timestamp":1785334702000},"page":"2291-2308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intra\u2010articular Orthobiologics Show Statistically but Not Clinically Meaningful Improvements Compared With Viscosupplementation in Knee Osteoarthritis: A Network Meta\u2010analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4276-3439","authenticated-orcid":false,"given":"Joo Hyung","family":"Han","sequence":"first","affiliation":[{"name":"Arthroscopy and Joint Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Orthopedic Surgery Severance Hospital, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7527-4802","authenticated-orcid":false,"given":"Min","family":"Jung","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Orthopedic Surgery Severance Hospital, Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3097-3332","authenticated-orcid":false,"given":"Kwangho","family":"Chung","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Orthopedic Surgery Yongin Severance Hospital, Yonsei University College of Medicine  Yongin Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8678-2960","authenticated-orcid":false,"given":"Hyun\u2010Soo","family":"Moon","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Department of Orthopedic Surgery Gangnam Severance Hospital, Yonsei University College of Medicine  Seoul Republic of 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