Treatment of Symptomatic Bilateral Knee Osteoarthritis: Intra-articular Injection of Autologous Microfragmented Adipose Tissue and Hyaluronic Acid vs Intra Articular Injection of Autologous Microfragmented Adipose Tissue

Who can take part

• Male or female patients aged between 18 and 75
• Radiographic evidence of bilateral OA of the knees graded between 2 and 4 on the Kellgren-Lawrence scale
• Pain equal to or greater than 4 on the Numeric Rating Scale (NRS) for both knees
• Failure, defined as persistence of symptoms after at least 6 months of conservative treatment (pharmacological, physiotherapy, or infiltration treatment)
• Ability and willingness to undergo the study procedures and comply with the instructions given by the study team; 6. No history of
• Failure, defined as persistent symptoms, after at least 6 months of conservative treatment (pharmacological, physiotherapy, or infiltration treatment); 5. Ability and consent of patients to actively participate in the rehabilitation and follow-up protocol; 6. Signature of informed consent

Who cannot take part

• Patients who abuse alcohol, drugs, or medications
• Patients with a history of trauma or intra-articular infiltration of therapeutic substances in the 6 months prior to screening
• Patients who have undergone knee surgery in the 12 months prior to screening
• Diagnosis of rheumatoid arthritis, Reiter's syndrome, psoriatic arthritis, gout, ankylosing spondylitis, or arthritis resulting from another inflammatory disease; human immunodeficiency virus (HIV) infection, active viral hepatitis; chondrocalcinosis
• Patients with uncontrolled diabetes mellitus
• Patients with uncontrolled thyroid metabolic disorders
• Patients incapable of understanding and willing
• Diagnosis of active neoplasia
• Patients with lower limb misalignment greater than 5°
• Body Mass Index > 35 kg/m2
• Pregnancy or breastfeeding, or plans to become pregnant during the study period
• Patients with insufficient abdominal adipose tissue, as assessed by the investigator