Assessment of safety and efficacy of intra-articular injection of stromal vascular fraction for the treatment of knee osteoarthritis—a systematic review

Shanmugasundaram, Saseendar; Vaish, Abhishek; K, Chavada V; Murrell, William; Vaishya, Raju

doi:10.1007/s00264-020-04926-x

Cited by 30 publications

(24 citation statements)

References 39 publications

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“…However, the effects of different doses of SVF cells were not examined 23 . Furthermore, promising results from several studies of intra-articular injections of SVF cells alone for knee OA were demonstrated, but their average doses varied from 1.4×10 7 to 5.0×10 7 cells 24 . Thus, we compared the short-term clinical and radiographic outcomes of different doses of intra-articular injections of SVF cells used to treat knee OA in a single institution.…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported excellent short-term clinical effects of intra-articular injection of 2.5×10 7 SVF cells on knee OA, but the effects of different doses of SVF cells were not examined 23 . Furthermore, promising results from several reports of intra-articular injections of SVF cells alone for knee OA were published, but their average doses varied from 1.4×10 7 to 5.0×10 7 cells 24 .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

et al. 2021

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Favorable clinical outcomes of intra-articular injection of adipose-derived stromal vascular fraction (SVF) cells for knee osteoarthritis (OA) have been reported, but the effects of different doses of SVF cells have not been examined. This study aimed to compare the short-term clinical and imaging outcomes of different doses of SVF cells for knee OA treatment. This study included 60 patients with knee OA who underwent intra-articular injection of SVF cells. The follow-up period was at least 12 months. Thirty patients received an intra-articular injection of 2.5×107 SVF cells (low-dose group), and the remaining 30 patients received an intra-articular injection of 5.0×107 SVF cells (high-dose group). Clinical evaluations were performed for the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, including the magnetic resonance imaging Osteoarthritis Knee Score (MOAKS) features (bone marrow lesions, cartilage defects, osteophytes, Hoffa’s synovitis, and effusion synovitis), were also performed. All clinical and imaging evaluations were performed preoperatively and 12 months postoperatively and compared between the groups. In demographic data, no significant differences were found between the two groups. The total score of KOOS at 12 months postoperatively was significantly more favorable than the preoperative score in the high-dose groups. Pain and symptoms subscale scores of KOOS at 12 months postoperatively were significantly better in the high-dose group than in the low-dose group. The bone marrow lesions, Hoffa’s synovitis, and effusion synovitis improved approximately 30–40% at 12 months postoperatively compared to baseline in both groups. However, there were no significant differences in imaging evaluations between the two groups. In conclusion, the pain and symptoms subscale scores of KOOS from baseline to 12 months postoperatively improved better in the high-dose group than in the low-dose group. Our findings suggest that intra-articular injection of SVF cells for knee OA is an innovative approach.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

et al. 2021

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“…In May 2021, we conducted a search in seven electronic databases: MEDLINE via PubMed, Epistemonikos, PEDro, DynaMed, TripDatabase, Elsevier via Clinicalkey and Cochrane Controlled Trials Register. In addition, we manually searched references from all available reviews 15 , 20 – 29 on SVF to verify that none were missing from our initial search. The search included the terms ‘stromal vascular fraction’, ‘knee osteoarthritis’ or ‘osteoarthritis’, ‘cartilage’, ‘adipose-derived stem cells’ or ‘adipose-derived stromal cells’, and ‘mesenchymal stem cells’ or ‘mesenchymal stromal cells’ in the title and abstract of all trial registers and databases.…”

Section: Methodsmentioning

confidence: 99%

“… 19 The most recently published systematic reviews and meta-analyses have pooled together, in the same analysis, different MSC therapy products, including SVF. 20 – 22 The comparison of different types of cell therapies could be misleading and induce biased conclusions, as has already been warned by some authors. 23 …”

Section: Introductionmentioning

confidence: 99%

Stromal vascular fraction therapy for knee osteoarthritis: a systematic review

Boada-Pladellorens

Avellanet

Pagés-Bolibar

et al. 2022

Therapeutic Advances in Musculoskeletal

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Background: Regenerative cell therapies, such as adipose-derived stromal vascular fraction (SVF), have been postulated as potential treatments for knee osteoarthritis (KOA). Objectives: To assess the efficacy and safety of SVF treatment against placebo and other standard therapies for treating KOA in adult patients. Design: A systematic review. Data sources and methods: We searched the following databases: MEDLINE via PubMed, Epistemonikos, PEDro, DynaMed, TripDatabase, Elsevier via Clinicalkey and Cochrane Controlled Trials Register. We included prospective interventional studies where treatment with SVF in adults with KOA was compared against placebo or other standard therapies, and results were objectively measured with at least one widely recognised osteoarthritis scale. Results: Among 266 studies published until May 2021, nine met our inclusion criteria. A total of 239 patients (274 knees) were included in our study. The follow-up ranged from 6 to 24 months. Six studies had a control group (only one being placebo). All studies showed that SVF improved pain and functionality measured, in most cases, with the visual analogue scale and the Western Ontario and McMaster Universities Osteoarthritis Index. In addition, five studies reported an improvement in anatomical structures, as detected in MR images. However, the number of cells contained in SVF varied substantially between different studies, which could induce a comparison bias. Conclusion: Although based on a small number of dissimilar studies, SVF was considered a safe treatment for KOA and could be promising in terms of pain, functionality and anatomical structure improvement. However, SVF products need to be standardised, the number of cells homogenised and the use of concomitant treatments reduced to establish proper comparisons. Registration: PROSPERO registration number: CRD42021284187.

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“…Unlike ADSC, SVF can be readily obtained from lipoaspirate without the need for cell separation or culturing, which makes SVF more cost-efficient and convenient [ 19 ]. The use of SVF has shown good results in all stages of knee OA, and in various age groups, their safety and efficacy significantly increased clinical and imaging outcomes [ 20 , 21 ]. Therefore, concomitant strategies could be implemented in conjunction with SVF injection treatments: high tibial osteotomy, platelet-rich plasma, and hyaluronic acid injections [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Short-term results of intra-articular injections of stromal vascular fraction for early knee osteoarthritis

et al. 2022

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Background In knee osteoarthritis, progressive degeneration of the articular cartilage surface produces disability and chronic pain. Intra-articular injections of stromal vascular fraction (SVF) could be an innovative approach to manage patients with early knee osteoarthritis. Methods Between June 2019 and November 2020, 123 patients were recruited to receive intra-articular injection of SVF. Radiographic evidence of degenerative joint disease was classified according to Kellgren and Lawrence grades. Knee injury and osteoarthritis outcome score (KOOS) and visual analog scale (VAS) were collected preoperatively, at 1 month, and after 6 months from injection. Results There was a statistically significant improvement of KOOS and VAS of all patients to 6 months (p < 0.05). The mean KOOS before injection was 51.4 ± 16.5, after 1 month it was 75.5 ± 15.8, and at 6 months it was 87.6 ± 7.7. Stratifying the mean KOOS according to Kellgren–Lawrence Grades, the difference remained statistically significant (p < 0.05). The patients’ mean VAS before injection was 6.5, after 1 month it was 3.5, and after 6 months it was 2.4. No complications were observed. Conclusions Intra-articular knee injection of SVF is safe and effective to ameliorate the clinical and functional scores in patients with early knee osteoarthritis for 6 months.

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Assessment of safety and efficacy of intra-articular injection of stromal vascular fraction for the treatment of knee osteoarthritis—a systematic review

Cited by 30 publications

References 39 publications

Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

Stromal vascular fraction therapy for knee osteoarthritis: a systematic review

Short-term results of intra-articular injections of stromal vascular fraction for early knee osteoarthritis

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