{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:32:26Z","timestamp":1791433946065,"version":"4.3.3"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this consensus was to develop evidence\/expert\u2010based patient\u2010focused recommendations on the appropriateness of intra\u2010articular point\u2010of\u2010care (POC) cell\u2010based therapy (CBT) injections in different clinical scenarios of patients with knee osteoarthritis (OA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The RAND\/UCLA Appropriateness Method was used by European experts of the\n                      <jats:italic>European Society of Sports Traumatology, Knee Surgery and Arthroscopy<\/jats:italic>\n                      (ESSKA) and the\n                      <jats:italic>International Cartilage Regeneration and Joint Preservation Society<\/jats:italic>\n                      (ICRS) to reach a consensus and produce recommendations for specific patient categories, combining best available scientific evidence with the collective judgement of a panel of experts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 144 scenarios were developed based on five factors: cell source (bone marrow vs. adipose tissue), age (&lt;50 vs. 50\u201365 vs. 66\u201380 vs. &gt;80 years), joint involvement (prevalent tibio\u2010femoral vs. patello\u2010femoral), OA level (Kellgren\u2013Lawrence [KL] Grade 0\u2013I vs. II\u2013III vs. IV) and body mass index (BMI) (&lt;18.5 vs. 18.5\u201335 vs. &gt;35\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Following two voting rounds, agreement was reached for all 144 (100%) scenarios: the indication was considered appropriate in 11.8%, inappropriate in 34.7% and uncertain in 53.5%. The parameters with the highest appropriateness were OA Grade II\u2013III (35.4% appropriate scenarios), age &lt;50 years (22.2% appropriate) and BMI 18.5\u201335\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (20.8% appropriate). The parameters with the highest inappropriateness were age &gt;80 years (88.9% inappropriate), OA grade IV (62.5% inappropriate) and BMI\u2009&gt;\u200935\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (50.0% inappropriate).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This ESSKA\u2013ICRS expert consensus provides recommendations on the appropriateness of cell\u2010based injectable therapies for knee OA. POC\u2010CBT may be considered, after failure of other non\u2010operative and injectable options, in patients aged \u226465 years with BMI\u2009\u2264\u200935\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and KL Grade II\u2013III OA. Unlike bone marrow\u2013derived CBT, adipose\u2010derived CBT was also considered appropriate in patients 66\u201380 years old with BMI 18.5\u201335\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and KL Grade II\u2013III OA. On the other hand, CBT was considered inappropriate in patients over 80 years old and in those with KL Grade IV OA. These findings may help improve patient selection, although they should not be interpreted as a rigid treatment algorithm but rather as expert\u2010informed guidance for the use of POC\u2010CBT in knee OA.\n                    <\/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.70487","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:55:11Z","timestamp":1782478511000},"page":"3052-3065","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cell\u2010based therapy injections for the management of knee osteoarthritis: The ESSKA\u2013ICRS consensus. Recommendations using the RAND\/UCLA appropriateness method for different clinical scenarios"],"prefix":"10.1002","volume":"34","author":[{"given":"Laura","family":"de Girolamo","sequence":"first","affiliation":[{"name":"IRCCS Ospedale Galeazzi Sant'Ambrogio, Orthopaedic Biotechnology Laboratory Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizaveta","family":"Kon","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Pieve Emanuele Milan Italy"},{"name":"IRCCS Humanitas Research Center, Rozzano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lior","family":"Laver","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Hillel Yaffe Medical Center (HYMC) Hadera Israel"},{"name":"Rappaport Faculty of Medicine Technion University Hospital, Israel Institute of Technology Haifa Israel"},{"name":"Arthrosport Clinic Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Andriolo","sequence":"additional","affiliation":[{"name":"Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-6900","authenticated-orcid":false,"given":"Angelo","family":"Boffa","sequence":"additional","affiliation":[{"name":"Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmin","family":"Bagge","sequence":"additional","affiliation":[{"name":"Sports Orthopedic Research Center\u2013Copenhagen (SORC\u2010C), Department of Orthopedic Surgery Copenhagen University Hospital\u2013Hvidovre Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer Weisskirchner","family":"Barfod","sequence":"additional","affiliation":[{"name":"Sports Orthopedic Research Center\u2013Copenhagen (SORC\u2010C), Arthroscopic Center, Department of Orthopedic Surgery Copenhagen University Hospital, Amager\u2010Hvidovre Hvidovre Denmark"},{"name":"Section for Sports Traumatology, Department of Orthopedic Surgery Copenhagen University Hospital \u2013 Bispebjerg and Frederiksberg Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Bastos","sequence":"additional","affiliation":[{"name":"Universiade Federal Fluminense Niter\u00f3i Rio de Janeiro Brazil"},{"name":"Hospital Trofa Sa\u00fade Penafiel Penafiel Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Cugat","sequence":"additional","affiliation":[{"name":"Instituto Cugat, Hospital Quironsalud Barcelona Barcelona Spain"},{"name":"Fundaci\u00f3n Garc\u00eda Cugat, Mutualidad de Futbolistas Espa\u00f1oles \u2013 Delegaci\u00f3n Catalana Barcelona 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