The relationship of body mass index on patient reported outcomes after platelet-rich plasma versus microfragmented adipose tissue for knee osteoarthritis: A secondary analysis of a randomized controlled trial

ABSTRACT Objective Body mass index (BMI) is known to contribute to outcomes for patients with knee OA. Furthermore, BMI influences the protein expression of orthobiologic treatments like platelet-rich plasma (PRP) and microfragmented adipose tissue (MFAT). We performed a secondary analysis of the association of BMI with PROs for patients with knee OA who received either PRP or MFAT injections. Methods Seventy-one patients with knee OA were randomized to receive a single ultrasound-guided injection of PRP or MFAT. PRP was created from 180cc of anti-coagulated blood and processed using a double-spin, buffy-coat concentration system. MFAT was created using autologous lipoaspirate that was processed according to minimal manipulation guidelines. PROs, and osteoarthritis outcome scores (KOOS) were tracked for 12-months. Results Forty-nine patients (PRP=23, MFAT=26) completed 12-month follow-up. KOOS- Quality of life and activity of daily living subscores were inversely correlated (both p < 0.05) with BMI in the MFAT but not PRPgroup. KOOS-Pain and Sport subscores showed a trend towards inverse correlation with BMI in the MFAT group (p = 0.07 and p = 0.06, respectively), but not PRP. Conclusion: BMI was negatively associated with PROs in patients who received MFAT injections for knee OA, but not for patients receiving PRP.