Discussion
pain, KOA
According to the main findings of the present study, intra-articular ADSCs or BMAC orthobiologic therapy improves clinical and functional scores in patients with symptomatic KOA at 6 months of follow-up with similar efficacies. Patients with mild KOA (K–L 2) treated with BMAC and ADSCs injections have better clinical and functional results than patients with moderate and severe KOA (K–L 3/4).Intra-articular MSCs for KOA may improve pain and function for 12 or 24 months, with no evidence of improvements in cartilage status in KOA [In MRI evaluations of cartilage repair, current evidence showed controversial results, with no improvement in cartilage status [Recent systematic reviews and network meta-analyses compared MCSs with other injectable intra-articular orthobiologic therapy [The total number of MSCs present in bone marrow harvests and lipoaspirates has not yet been estimated [This study has some limitations. First, the choice of treatment was not randomized. Furthermore, there was no comparison with other therapies, such as placebo or other injection such as hyaluronic acid, PRP, and corticosteroid. Another important limitation of this study was the short- term follow-up. Also, we evaluated only patient-reported outcome measures, without considering the biological effects of mesenchymal cells on cartilage repair, which can be assessed by MRI. Only another study directly compared the results between autologous BMAC or ADSCs as tissue sources of MSCs for symptomatic KOA and showed significant improvement in clinical outcomes with both BMAC and ADSCs injections, without a significant difference between the two autologous tissue sources [