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

Tsubosaka, Masanori; Matsumoto, Tomoyuki; Matsushita, Takehiko; Iwaguro, Hideki; Kuroda, Ryosuke

doi:10.1177/09636897211067454

Cited by 13 publications

(20 citation statements)

References 60 publications

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“…All the included studies used autologous-derived MSCs. Seven studies used MSCs provided by the abdominal adipose tissue [ 1 , 10 , 21 , 27 – 29 ], four used bone marrow from the iliac crest [ 2 , 7 , 22 , 24 ], and one from both sources [ 3 ]. Different reported devices were used for harvesting adipose or bone marrow-derived MSCs (Celution, Lipogems, Lipocell, GID SVF-2, PureBMC) [ 2 , 8 , 10 , 21 , 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, almost all studies have shown shortterm clinical outcomes, and thus the interpretation of these results should be made cautiously. One of the studies showed the K-L grade 2 and 3 OA results separately and demonstrated more remarkable progress in the case of grade 2 arthritis which was predictable [21].…”

Section: Discussionmentioning

confidence: 98%

“…The VAS was mainly used to evaluate pain relief, and eight studies [1,7,10,21,22,[27][28][29] assessed it at baseline and after administration. The follow-up period was ranged between 3 months to 5 years, and the improvement varied between 0.9 to 5.2 points.…”

Section: Discussionmentioning

confidence: 99%

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Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Kyriakidis,

Pitsilos,

Iosifidou

et al. 2023

J. exp. orthop.

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Purpose Mesenchymal stem cells (MSCs) present a valuable treatment option for knee osteoarthritis with promising results. The purpose of the present study was to systematically review the clinical and functional outcomes following mesenchymal stem cell application focusing on early to moderate knee osteoarthritis. Methods A systematic search was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Pubmed, Scopus, Web of Science, and Cochrane Library databases. All Studies published between 2017 and March 2023 on patients treated with single mesenchymal stem cell injection for Kellgren-Lawrence grade I—III knee osteoarthritis reported on clinical and functional outcomes were included. Results Twelve articles comprising 539 patients and 576 knees treated with a single intraarticular injection of MSCs for knee osteoarthritis were included in the current systematic review. In eligible studies, the reported outcomes were improved concerning patient-reported outcomes measures, knee function, pain relief, and quality of patient's life. Conclusion Based on high-level evidence studies, single intraarticular injection of MSCs is a safe, reliable, and effective treatment option for Kellgren-Lawrence grade I—III knee osteoarthritis. However, the lack of homogeneity in the included studies and the variance in MSCs sources and preparations should be noted. Level of evidence III.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

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Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Kyriakidis,

Pitsilos,

Iosifidou

et al. 2023

J. exp. orthop.

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“…Meanwhile, other authors reported positive correlations between SVF‐based treatment outcomes and the number of SVF cells. Tsubosaka et al [38] compared the 12‐month outcomes of 60 patients; 30 received an intra‐articular injection with 2.5 × 10 7 SVF cells (low‐dose group), and 30 received an intra‐articular injection of 5.0 × 10 7 SVF cells (high‐dose group). They reported that the 12‐month postoperative pain and symptom subscale KOOS scores were significantly better in the high‐dose group than in the low‐dose group.…”

Section: Discussionmentioning

confidence: 99%

Cartilage lesion size and number of stromal vascular fraction (SVF) cells strongly influenced the SVF implantation outcomes in patients with knee osteoarthritis

Kim

Suh

et al. 2023

J. exp. orthop.

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Purpose This study evaluated outcomes in patients with knee osteoarthritis following stromal vascular fraction implantation and assessed the associated prognostic factors. Methods We retrospectively evaluated 43 patients who underwent follow-up magnetic resonance imaging 12 months after stromal vascular fraction implantation for knee osteoarthritis. Pain was assessed using the visual analogue scale and measured at baseline and 1-, 3-, 6-, and 12-month follow-up appointments. In addition, cartilage repair was evaluated based on the Magnetic Resonance Observation of Cartilage Repair Tissue scoring system using the magnetic resonance imaging from the 12-month follow-up. Finally, we evaluated the effects of various factors on outcomes following stromal vascular fraction implantation. Results Compared to the baseline value, the mean visual analogue scale score significantly and progressively decreased until 12 months post-treatment (P < 0.05 for all, except n.s. between the 1 and 3-month follow-ups). The mean Magnetic Resonance Observation of Cartilage Repair Tissue score was 70.5 ± 11.1. Furthermore, the mean visual analogue scale and Magnetic Resonance Observation of Cartilage Repair Tissue scores significantly correlated 12 months postoperatively (P = 0.002). Additionally, the cartilage lesion size and the number of stromal vascular fraction cells significantly correlated with the 12-month visual analogue scale scores and the Magnetic Resonance Observation of Cartilage Repair Tissue score. Multivariate analyses determined that the cartilage lesion size and the number of stromal vascular fraction cells had a high prognostic significance for unsatisfactory outcomes. Conclusion Stromal vascular fraction implantation improved pain and cartilage regeneration for patients with knee osteoarthritis. The cartilage lesion size and the number of stromal vascular fraction cells significantly influenced the postoperative outcomes. Thus, these findings may serve as a basis for preoperative surgical decisions. Level of evidence IV.

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“…Pain decreased and function improved in those patients with time. The effectiveness of the intra-articular injection of SVF could be cell-dose dependent [ 168 ]. The higher dose had better outcomes in 60 patients.…”

Section: Adipose Derived Stromal Vascular Fraction (Ad-svf)mentioning

confidence: 99%

Autologous Adipose-Derived Tissue Stromal Vascular Fraction (AD-tSVF) for Knee Osteoarthritis

Vargel

Tuncel

Baysal

et al. 2022

IJMS

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Adipose tissue contains adult mesenchymal stem cells that may modulate the metabolism when applied to other tissues. Stromal vascular fraction (SVF) can be isolated from adipose tissue mechanically and/or enzymatically. SVF was recently used to decrease the pain and improve the function of knee osteoarthritis (OA) patients. Primary and/or secondary OA causes inflammation and degeneration in joints, and regenerative approaches that may modify the natural course of the disease are limited. SVF may modulate inflammation and initiate regeneration in joint tissues by initiating a paracrine effect. Chemokines released from SVF may slow down degeneration and stimulate regeneration in joints. In this review, we overviewed articular joint cartilage structures and functions, OA, and macro-, micro-, and nano-fat isolation techniques. Mechanic and enzymatic SVF processing techniques were summarized. Clinical outcomes of adipose tissue derived tissue SVF (AD-tSVF) were evaluated. Medical devices that can mechanically isolate AD-tSVF were listed, and publications referring to such devices were summarized. Recent review manuscripts were also systematically evaluated and included. Transferring adipose tissues and cells has its roots in plastic, reconstructive, and aesthetic surgery. Micro- and nano-fat is also transferred to other organs and tissues to stimulate regeneration as it contains regenerative cells. Minimal manipulation of the adipose tissue is recently preferred to isolate the regenerative cells without disrupting them from their natural environment. The number of patients in the follow-up studies are recently increasing. The duration of follow up is also increasing with favorable outcomes from the short- to mid-term. There are however variations for mean age and the severity of knee OA patients between studies. Positive outcomes are related to the higher number of cells in the AD-tSVF. Repetition of injections and concomitant treatments such as combining the AD-tSVF with platelet rich plasma or hyaluronan are not solidified. Good results were obtained when combined with arthroscopic debridement and micro- or nano-fracture techniques for small-sized cartilage defects. The optimum pressure applied to the tissues and cells during filtration and purification of the AD-tSVF is not specified yet. Quantitative monitoring of articular joint cartilage regeneration by ultrasound, MR, and synovial fluid analysis as well as with second-look arthroscopy could improve our current knowledge on AD-tSVF treatment in knee OA. AD-tSVF isolation techniques and technologies have the potential to improve knee OA treatment. The duration of centrifugation, filtration, washing, and purification should however be standardized. Using gravity-only for isolation and filtration could be a reasonable approach to avoid possible complications of other methodologies.

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

Cited by 13 publications

References 60 publications

Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Cartilage lesion size and number of stromal vascular fraction (SVF) cells strongly influenced the SVF implantation outcomes in patients with knee osteoarthritis

Autologous Adipose-Derived Tissue Stromal Vascular Fraction (AD-tSVF) for Knee Osteoarthritis

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