Intra-articular injection of stromal vascular fraction for knee degenerative joint disease: a concise review of preclinical and clinical evidence

Liu, Yuan; Huang, Liping; Zeng, Yi; Li, Mingyang; Xie, Huiqi; Shen, Bin

doi:10.1007/s11427-021-2090-3

Cited by 4 publications

(3 citation statements)

References 70 publications

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“…This result suggests that adipose tissue injection leads to immediate pain reduction, but mouth opening only improves after 6 months. Pain reduction and functional improvement have also been seen with osteoarthritic knees following this procedure [15,[53][54][55]. To our knowledge, there are no animal trials describing the injection of tSVF in TMJ osteoarthritis models.…”

Section: Discussionmentioning

confidence: 96%

Intra-Articular Injection of Adipose-Derived Stromal Vascular Fraction in Osteoarthritic Temporomandibular Joints: Study Design of a Randomized Controlled Clinical Trial

Schipper,

Tuin,

van Dongen

et al. 2024

Bioengineering

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Introduction: Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease of the TMJ. It is characterized by progressive degradation of the extracellular matrix components of articular cartilage, with secondary inflammatory components leading to pain in the temporomandibular region and reduced mouth opening. Current treatments do not halt disease progression, hence the need for new therapies to reduce inflammation and, consequently, improve symptoms. The aim of our randomized controlled clinical trial protocol is to investigate the efficacy of adjuvant intra-articular injections of autologous tissue-like stromal vascular fraction (tSVF), compared to arthrocentesis alone, in reducing pain and improving mouth opening in TMJ osteoarthritis patients. Materials and Methods: The primary endpoint analysis will consist of the visual analogue scale (VAS) for pain. The secondary endpoint analyses will include maximal interincisal mouth opening measurements; assessment of oral health and mandibular function based on the oral health impact profile (OHIP) questionnaire and mandibular functional impairment questionnaire (MFIQ); complications during the follow up; synovial cytokine analysis at baseline and after 26 weeks; and nucleated cells and tSVF (immuno)histochemistry analyses of the intervention group. Discussion: Our randomized clinical trial protocol will be applied to evaluate the efficacy of a new promising tSVF injection therapy for TMJ osteoarthritis. The safety of intra-articular injections of tSVF has been proven for knee osteoarthritis. However, since a tSVF injection is considered a heterologous application of cell therapy, the regulatory requirements are strict, which makes medical ethical approval challenging.

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Section: Discussionmentioning

confidence: 96%

Intra-Articular Injection of Adipose-Derived Stromal Vascular Fraction in Osteoarthritic Temporomandibular Joints: Study Design of a Randomized Controlled Clinical Trial

Schipper,

Tuin,

van Dongen

et al. 2024

Bioengineering

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“…A recent review [ 268 ] highlighted that SVF was more effective than bone marrow autologous cells for knee pain. Magnetic resonance quantification after the treatment of knee OA with SVF is enhancing in recent studies [ 269 ].…”

Section: Discussionmentioning

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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“…Under appropriate culture conditions, cells in SVF can differentiate into adipocytes, pericytes, osteoblasts, chondrocytes, and myocytes, which have a positive effect on vascular and cartilage regeneration and tissue repair. SVF proves easier to extract and has more signi cant therapeutic effects compared to other intra-articular injection drugs such as platelet-rich plasma (PRP), sodium hyaluronate, glucocorticoids, medical ozone, hypertonic glucose, and medical chitosan [15][16][17]. SVF has been applied in treating various osteoarthritis, tendon injuries, and skin aging diseases.…”

mentioning

confidence: 99%

Autologous adipose-derived vascular stromal component injection offers a safe and effective method for treating knee osteoarthritis: A one-year double-blind, randomized controlled clinical trial

Lu,

Xu,

et al. 2023

Preprint

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Background: Currently, conservative treatment for knee osteoarthritis (KOA) has limited efficacy, and autologous adipose-derived stromal vascular fraction (SVF) knee injections as a novel treatment approach are receiving widespread attention. Our study aimed to explore the efficacy and safety of SVF treatment for KOA patients. Methods: This double-blind, randomized controlled trial recruited unilateral KOA patients from the Rehabilitation Departments of the First, Second, and Third Affiliated Hospitals of Gannan Medical University. Sixty-six unilateral KOA participants were randomly divided into three groups for conventional treatment, SVF treatment, and a combination of SVF and conventional treatment. We compared the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, Visual Analogue Scale (VAS) scores, range of motion (ROM) of the knee, cartilage degeneration situation, and the incidence, nature, and severity of adverse events after treatment at 7 days, 1 month, 6 months, and 12 months. Results:A total of 62 patients completed the follow-up. There were no significant baseline differences among the groups. Our results demonstrated that, compared to baseline values, average VAS and WOMAC scores significantly decreased, while ROM significantly increased in the SVF and combination treatment groups during the 12-month follow-up, with a significant difference when compared to the control group (P< 0.05). Cartilage regeneration was observed in the combination treatment group at the 12-month follow-up (P < 0.05). No serious adverse events were observed during the 12-month follow-up, and no significant difference was noted in the incidence of complications among the three groups (P > 0.05). Conclusion:A single SVF injection demonstrates good safety, no serious adverse reactions, and can achieve better therapeutic effects when combined with conventional treatment, which is worth further investigation and promotion in clinical practice. Trial registration Chinese Clinical Trial Registry (ChiCTR2300074894). First trial registration in the format 18/08/2023

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Intra-articular injection of stromal vascular fraction for knee degenerative joint disease: a concise review of preclinical and clinical evidence

Cited by 4 publications

References 70 publications

Intra-Articular Injection of Adipose-Derived Stromal Vascular Fraction in Osteoarthritic Temporomandibular Joints: Study Design of a Randomized Controlled Clinical Trial

Intra-Articular Injection of Adipose-Derived Stromal Vascular Fraction in Osteoarthritic Temporomandibular Joints: Study Design of a Randomized Controlled Clinical Trial

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

Autologous adipose-derived vascular stromal component injection offers a safe and effective method for treating knee osteoarthritis: A one-year double-blind, randomized controlled clinical trial

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