In this editorial, we comment on the paper by Muthu et al published in the recent issue of the journal. This editorial review focusses on the use of adipose-derived stem cells (ADSCs) in knee osteoarthritis treatment. We discuss the differences between the stromal vascular fraction and microfragmented adipose tissue and highlight the results of clinical studies comparing both treatments and the use of hyaluronic acid, platelet-rich plasma, and bone marrow aspirate concentrate. The use of expanded ADSCs is also discussed; moreover, concerns regarding treatment with ADSCs, particularly the heterogeneity of published studies and the need to standardize protocols to explore clinical potential is explored.