Effectiveness of amnion allograph injections in patients with degenerative musculoskeletal diseases: a systematic review and meta-analysis

Objective Amnion allograft injections have emerged as potential regenerative therapy for degenerative musculoskeletal diseases. In this study, we conducted a systematic review and meta-analysis to evaluate the effectiveness of amnion allograph injections in patients with degenerative musculoskeletal diseases. Design A search was conducted across the PubMed, Embase, Cochrane, and Web of Science databases to identify studies reporting on amnion allograft injections in patients with degenerative musculoskeletal diseases. The outcomes assessed were pain reduction at different time points, physical functional improvements, and quality of life (QoL). Results In total, seven studies were included. The quality assessment indicated that only three studies had a low overall risk of bias. Pooled effect sizes indicated significant improvements in overall pain of -0.959 (95% confidence interval (CI): -1.483 ∼ -0.435, p < 0.001), pain at 2-4 weeks of -2.609 (95% CI: -3.334 ∼ -1.884, p < 0.001), at 3-6 months of 0.834 (95% CI: -1.077 ∼ -0.590, p < 0.001), and at 1-2 years of -0.518 (95% CI: -1.025 ∼ -0.011, p = 0.045), physical function of 0.679 (95% CI: 0.202 ∼ 1.156, p = 0.005), and QoL of 1.407 (95% CI: 0.273 ∼ 2.541, p = 0.015). No significant covariant was identified by subgroup analyses. Conclusions Results indicated that amnion allograft injections produced significant pain reduction, functional improvement, and QoL enhancement in patients receiving injections compared to control groups, particularly in terms of pain reduction.