Is there a role for autologous conditioned serum injections in osteoarthritis? A systematic review and meta-analysis of randomised controlled trials
Authors' conclusion
There is currently insufficient data to support the use of ACS in osteoarthritis with conflicting results when compared to alternative therapies and saline control, with high heterogeneity.
Study context
- Population
- Patients with OA; RCTs comparing autologous conditioned serum (ACS) vs comparators/controls, searched to March 2024
- Participants
- 741 patients5 RCTs
- Comparison
- ACS vs comparators/controls
- Salinen = 529reference
- Outcome
- Pain, function and stiffness measured with WOMAC and VAS
- Follow-up
- 6 months
Methodological detailsRisk of bias (RoB) 2, GRADE, sensitivity analysis vs saline control, Three studies "some concern" and two "high risk" for bias
- RoB 2
- GRADE
- Sensitivity analysis vs saline control
- Three studies "some concern" and two "high risk" for bias
Pooled result
As reported in the abstract
Each group vs comparatorsEstimate (95% CI)P value
ACS
SMD (WOMAC) −0.61(−1.01 to −0.21)
P = 0.003ACS
SMD (VAS) −1.24(−2.11 to −0.38)
P = 0.005Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| WOMAC and VAS, ACS vs saline (2 RCTs) · 6 monthsACSvs Saline | SMD (WOMAC) −0.40 (95% CI −0.93 to 0.12) | P = 0.13 | |
| WOMAC and VAS, ACS vs saline (2 RCTs) · 6 monthsACSvs Saline | MD (VAS) −9.87 (95% CI −27.73 to 7.98) | P = 0.28 | |
| −40−20020Difference (linear scale) |
WOMAC and visual analogue scale (VAS), ACS vs saline (2 RCTs) · 6 months
- No significant difference in WOMAC or VAS
Safety
| Outcome | ACS | Saline |
|---|---|---|
| Complications | 24.8% | 24.4% |
Complications
- Similar; serious complications rare
Original publication
Is there a role for autologous conditioned serum injections in osteoarthritis? A systematic review and meta-analysis of randomised controlled trials. Osteoarthritis Cartilage. Published 13 June 2024. doi:10.
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