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Bone marrow aspirate concentrate has been promoted as a regenerative option for knee osteoarthritis, but high-quality clinical evidence remains limited. In this prospective randomized placebo-controlled trial, patients with mild-to-moderate knee osteoarthritis received bone marrow aspirate concentrate in one knee and saline placebo in the other, allowing within-patient comparison. The study evaluated pain, function and structural outcomes over follow-up and demonstrated that BMAC is feasible and generally well tolerated, while also highlighting the uncertainty around its magnitude of benefit compared with placebo. The clinical relevance of the study is that it moved BMAC evaluation beyond uncontrolled case series and into a randomized framework. However, the relatively small sample size means that the results should not be treated as definitive proof of disease modification. For orthopaedic practice, BMAC remains an evolving intervention whose biological rationale is stronger than the current certainty of clinical evidence. Patient selection, expectation management and transparent discussion of alternatives are therefore essential. Conventional evidence-based OA care—including exercise, weight management where appropriate, symptom control and consideration of established injections or arthroplasty when indicated—should not be displaced by regenerative marketing.
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Bone marrow aspirate concentrate has been promoted as a regenerative option for knee osteoarthritis, but high-quality clinical evidence remains limited. In this prospective randomized placebo-controlled trial, patients with mild-to-moderate knee osteoarthritis received bone marrow aspirate concentrate in one knee and saline placebo in the other, allowing within-patient comparison. The study evaluated pain, function and structural outcomes over follow-up and demonstrated that BMAC is feasible and generally well tolerated, while also highlighting the uncertainty around its magnitude of benefit compared with placebo. The clinical relevance of the study is that it moved BMAC evaluation beyond uncontrolled case series and into a randomized framework. However, the relatively small sample size means that the results should not be treated as definitive proof of disease modification. For orthopaedic practice, BMAC remains an evolving intervention whose biological rationale is stronger than the current certainty of clinical evidence. Patient selection, expectation management and transparent discussion of alternatives are therefore essential. Conventional evidence-based OA care—including exercise, weight management where appropriate, symptom control and consideration of established injections or arthroplasty when indicated—should not be displaced by regenerative marketing.
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