Effects of cetylated fatty acids on knee osteoarthritis: a systematic review and meta-analysis of real-world evidence.

OBJECTIVES: Knee osteoarthritis (OA) continues to be a debilitating global health issue, with effective treatments that have minimal side effects still lacking in modern clinical practice. Cetylated fatty acids (CFAs), a group of esterified fatty acids administered either topically or orally to protect the synovial membrane and stabilise cell membranes, appears to be a promising therapeutic option. METHODS: We conducted a comprehensive search in PubMed, Embase, Cochrane Library, CENTRAL, and Web of Science from the inception until November 2024 to examine the therapeutic effects of CFAs. We included randomised controlled trials (RCTs) with a CFA intervention group compared with a control group that received either a placebo or a non-CFA treatment, as well as pre-post experimental studies that investigate pre-treatment and post-treatment CFA interventions. Subgroup analyses for different forms of CFAs were also conducted. RESULTS: A total of 5 RCTs and 2 pre-post experimental studies with 357 participants were included. Significant improvements were observed in pain levels (SMD= -0.37, 95% CI= -0.60 to -0.15, p=0.0009), knee ROM (SMD=7.80, 95% CI=4.15 to 11.45, p