{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:11:18Z","timestamp":1791832278416,"version":"4.3.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Microfragmented adipose tissue has been proposed for intra-articular treatment of knee osteoarthritis. There are little data comparing the outcomes of treatment between microfragmented adipose tissue and other biological treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To perform a systematic review and meta-analysis comparing microfragmented aspirated fat injections to other orthobiologics, hyaluronic acid, and corticosteroid injections for symptomatic knee osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A systematic review of the literature was performed to identify pertinent publications in the MEDLINE, Embase, Scopus, and Google Scholar databases, including all level 1 to 3 studies from 2000 to 2023. Validated knee scores (visual analog scale [VAS] for pain, Knee injury and Osteoarthritis Outcome Score [KOOS], Lysholm, International Knee Documentation Committee) were included as outcome measures. Risk of bias was assessed using Cochrane tools. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the quality of the body of evidence and the modified Coleman Methodology Score was used to assess study quality. Heterogeneity was assessed using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      and\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five studies were included in the analysis. One study had a high risk of bias; 4 studies had some risk of bias. The overall study quality was fair, and the certainty of evidence was low. The pooled estimate for VAS scores did not demonstrate significant differences at 3, 6, and 12 months. The pooled estimate for the KOOS Pain, Symptoms, Activities of Daily Living, Sport and Recreation, and Quality of Life subscales did not demonstrate significant differences at 3, 6, and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results of this systematic review and meta-analysis demonstrated that there were no statistically significant differences for both the clinical outcomes and pain scores between microfragmented adipose tissue and other orthobiologics for the treatment of knee osteoarthritis. However, modest study quality, some risk of bias, and low certainty of evidence reduce external validity, and these results must be viewed with some caution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241249940","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T10:53:34Z","timestamp":1735901614000},"page":"988-998","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Microfragmented Adipose Tissue Has No Advantage Over Platelet-Rich Plasma and Bone Marrow Aspirate Injections for Symptomatic Knee Osteoarthritis: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"53","author":[{"given":"Erik","family":"Hohmann","sequence":"first","affiliation":[{"name":"Medical School, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa"},{"name":"Department of Orthopaedic Surgery and Sports Medicine, Burjeel Hospital for Advanced Surgery, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Keough","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Clinical Anatomy and Imaging, Warwick Medical School, University of Warwick, Coventry, United Kingdom"},{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-0521","authenticated-orcid":false,"given":"Rachel M.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Colorado, School of Medicine, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-9880","authenticated-orcid":false,"given":"Scott A.","family":"Rodeo","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Weill Medical College of Cornell University, New York, New York, USA"},{"name":"Hospital for Special Surgery, New York, New York, USA"},{"name":"New York Giants Football, East Rutherford, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2021.04.020"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2019.06.011"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221120678"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.03.009"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.03.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-021-00387-2"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.10.018"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2019.10.013"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13221-016-0037-3"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06887-7"},{"key":"e_1_3_2_12_2","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988","unstructured":"Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Erlbaum; 1988.","edition":"2"},{"key":"e_1_3_2_13_2","article-title":"Updated guidance for trusted systematic reviews: a new edition of the","volume":"10","author":"Cumpston M","year":"2019","unstructured":"Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;10:ED000142.","journal-title":"Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.10.016"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/scd.2021.0053"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.05.031"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07139-4"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-021-04947-0"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001026"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9921015"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8881405"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.10.002"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-020-02623-4"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-2300-7"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10030684"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-014-0144-x"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9516-x"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231179223"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04711-w"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/sctm.18-0285"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02632-w"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-021-05628-4"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11092640"},{"issue":"1","key":"e_1_3_2_36_2","first-page":"52","article-title":"The use of intra-articular injection of micro-fragmented adipose tissue as pain treatment for ankle-osteoarthritis: a prospective not randomized study","volume":"8","author":"Natali S","year":"2021","unstructured":"Natali S, Screpis D, Farinelli L, Iacono V, Vacca V, Gigante A. The use of intra-articular injection of micro-fragmented adipose tissue as pain treatment for ankle-osteoarthritis: a prospective not randomized study. J Exp Orthop. 2021;8(1):52.","journal-title":"J Exp Orthop"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2023.101835"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232314953"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13861"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-018-0169-x"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2023.102226"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-023-03332-5"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520981704"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mporth.2023.03.002"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511419278"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112231"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1204144"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm13030504"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221115821"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465241249940","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03635465241249940","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465241249940","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T08:38:34Z","timestamp":1779266314000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03635465241249940"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1177\/03635465241249940"],"URL":"https:\/\/doi.org\/10.1177\/03635465241249940","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}