{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:56:58Z","timestamp":1792177018797,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) formal consensus aims to provide evidence\u2010 and expert opinion\u2010based recommendations for the use of point\u2010of\u2010care\u2010 and expanded\u2010cell\u2010based therapy (CBT) in the treatment of knee osteoarthritis (OA), focusing on indications, preparation, and administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multidisciplinary group of 77 leading experts in musculoskeletal regenerative medicine from 22 European Countries formed a steering group, a rating group, and a reader group. The steering group developed 23 questions, originating from 27 statements. The statements were graded from A (high\u2010level scientific evidence) to D (expert opinion). The question\u2010statement sets were scored by the rating group from 1 to 9 according to the level of agreement. The document was then assessed for geographic adaptability by the reader group composed of\u00a0representatives from ESSKA\u2010affiliated societies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, the statements received a mean score of 8.2 (standard deviation: 0.3) points out of a possible 9 and a median score of 8 (range: 6\u20139). Among the 27 statements, 9 were considered appropriate with strong agreement, and 18 were considered appropriate with relative agreement. Five statements received a recommendation level of A or B, and 22 were rated as C or D. In terms of geographic adaptability, 18 affiliated ESSKA Societies expressed support, two were opposed, and two abstained. CBT has demonstrated consistent clinical benefits, particularly in pain and function improvement up to 12 months, supporting its use for patients with Kellgren\u2013Lawrence (KL) Grades 1\u20133 knee OA, with some benefits, though inferior, in selected KL Grade 4. However, due to limited high\u2010quality studies and a lack of clear superiority over other injectables, CBT should be considered as a second\u2010line treatment option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The consensus document acknowledges ongoing debate about CBT's full effectiveness, though evidence suggests potential clinical benefits in pain relief and functional improvement. CBT are supported as a second\u2010line injectable treatment for KL 1\u20133 knee OA 1\u20133, with some benefits shown in Grade 4 too. However, gaps remain in high\u2010quality studies and treatment protocols. Nevertheless, evidence suggests that CBT may be seen as an alternative to traditional injectables like corticosteroids and hyaluronic acid, given the longer\u2010lasting benefits, and could currently be considered after other non\u2010operative treatment fails.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70001","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T10:07:24Z","timestamp":1757412444000},"page":"4079-4095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The use of injectable orthobiologics for knee osteoarthritis: A formal ESSKA\u2010ORBIT consensus. Part 2\u2014Cell\u2010based therapy"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9979-3092","authenticated-orcid":false,"given":"Laura","family":"de Girolamo","sequence":"first","affiliation":[{"name":"Orthopaedic Biotechnology Laboratory IRCCS Ospedale Galeazzi Sant'Ambrogio Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Filardo","sequence":"additional","affiliation":[{"name":"Service of Orthopaedics and Traumatology, Department of Surgery EOC Lugano Switzerland"},{"name":"Faculty of Biomedical Sciences Universit\u00e0 Della Svizzera Italiana Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Abat","sequence":"additional","affiliation":[{"name":"Sports Orthopaedic Department, ReSport Clinic, Higher School of Health Sciences Tecnocampus, GRACIS Research Group (GRC 01604) Pompeu Fabra University Barcelona 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