Retrospective comparison of adipose-derived mesenchymal stem cell and corticosteroid ınjections on pain and function in knee osteoarthritis and the association with osteoarthritis stages

This study aimed to evaluate the short-term effects of adipose-derived mesenchymal stem cell (ADMSC) and corticosteroid (steroid) injections on pain and function in patients with Kellgren–Lawrence (KL) grade 2 and 3 knee osteoarthritis, and to compare these effects across treatment groups and KL grades. This retrospective study included 27 patients with knee osteoarthritis who underwent intra-articular injection of stromal vascular fraction (SVF) containing uncultured ADMSCs between June 1, 2023, and July 15, 2024, along with 27 patients who received corticosteroid injections matched for age, sex, and Kellgren–Lawrence grade. The patients' demographic characteristics, Kellgren–Lawrence grade, and clinical scores at baseline, 4th, and 12th weeks after the injection were recorded. The changes in clinical scores over time were analyzed according to Kellgren–Lawrence grade and treatment groups, and comparisons were made between the groups. Pain was assessed using the Visual Analog Scale (VAS) and the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), while functional status was evaluated using the Lequesne index and the stiffness, physical function, and total subscales of the WOMAC. While no significant baseline differences were observed, both groups showed significant improvement in pain and functional outcomes. A significant clinical response was observed at week 4 in the steroid group, but this effect decreased by week 12. In the MSC group, significant improvement was seen at week 4 and became more pronounced by week 12. Nevertheless, no statistically significant differences were found between the two groups at either the 4th or 12th week assessments.In the subgroup analyses based on KL grades, no significant difference was observed between grade 2 and grade 3 patients in the steroid group, whereas in the MSC group, pain and function scores were lower in grade 2 patients compared to those with grade 3. In the comparison between groups, patients with KL grade 2 showed significantly lower functional scores in the MSC group at week 4, whereas patients with KL grade 3 had lower pain and functional scores in the steroid group at the same time point. In conclusion, both injection methods provided significant and similar improvement in pain and functional parameters in knee osteoarthritis. The steroid group showed a more pronounced effect at week 4, while the MSC group showed improvement at week 4 that became more evident by week 12. In KL-based analysis, no difference was observed between stages in the steroid group, while better clinical response was seen in stage 2 patients in the MSC group. In intergroup comparisons, MSC injection was more favorable in stage 2 patients in the early period, whereas steroid injection was more advantageous in stage 3 patients. These findings suggest that treatment response may vary depending on the type of injection and the radiological stage of the disease.