Limited evidence for adipose-derived stem cell therapy on the treatment of osteoarthritis

Hurley, Eoghan T.; Yasui, Youichi; Gianakos, Arianna L.; Seow, Dexter; Shimozono, Yoshiharu; Kerkhoffs, Gino M. M. J.; Kennedy, John G.

doi:10.1007/s00167-018-4955-x

Cited by 59 publications

(64 citation statements)

References 44 publications

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“…“Tissue engineering” has generally focused on combining cells, biomaterial scaffolds, and environmental factors (e.g., growth factors and bioreactors) to regenerate tissue replacements for implantation. Despite tremendous progress in these areas, however, there have been few long‐term successes in the translation of stem cell therapies to clinical therapies . Preclinical studies for tissue‐engineered repair of cartilage and bone have been quite promising, but most clinical procedures either lack controls or have shown long‐term results that are equivocal to standard‐of‐care .…”

Section: Stem Cell Research and Therapy In Orthopedicsmentioning

confidence: 99%

“…Despite tremendous progress in these areas, however, there have been few long-term successes in the translation of stem cell therapies to clinical therapies. 15,16 Preclinical studies for tissue-engineered repair of cartilage and bone have been quite promising, but most clinical procedures either lack controls or have shown long-term results that are equivocal to standard-of-care. 17,18 Similarly, stem cell therapies have shown significant promise in controlled preclinical animal studies, [19][20][21] but have not shown consistent clinical efficacy in prospective and randomized trials.…”

Section: Stem Cell Research and Therapy In Orthopedicsmentioning

confidence: 99%

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Designer Stem Cells: Genome Engineering and the Next Generation of Cell‐Based Therapies

Guilak

Pferdehirt

Ross

et al. 2019

Journal Orthopaedic Research

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Stem cells provide tremendous promise for the development of new therapeutic approaches for musculoskeletal conditions. In addition to their multipotency, certain types of stem cells exhibit immunomodulatory effects that can mitigate inflammation and enhance tissue repair. However, the translation of stem cell therapies to clinical practice has proven difficult due to challenges in intradonor and interdonor variability, engraftment, variability in recipient microenvironment and patient indications, and limited therapeutic biological activity. In this regard, the success of stem cell‐based therapies may benefit from cellular engineering approaches to enhance factors such as purification, homing and cell survival, trophic effects, or immunomodulatory signaling. By combining recent advances in gene editing, synthetic biology, and tissue engineering, the potential exists to create new classes of “designer” cells that have prescribed cell‐surface molecules and receptors as well as synthetic gene circuits that provide for autoregulated drug delivery or enhanced tissue repair. Published by Wiley Periodicals, Inc. J Orthop Res 37:1287–1293, 2019.

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Section: Stem Cell Research and Therapy In Orthopedicsmentioning

confidence: 99%

Section: Stem Cell Research and Therapy In Orthopedicsmentioning

confidence: 99%

Designer Stem Cells: Genome Engineering and the Next Generation of Cell‐Based Therapies

Guilak

Pferdehirt

Ross

et al. 2019

Journal Orthopaedic Research

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“…These studies had favorable clinical outcomes with minimal complications in the treatment of knee OA. 44 Pak et al in 2013 reported a retrospective cohort study involving 91 patients, including knee and hip OA, with percutaneous injections of autologous adipose SVF from the abdomen along with autologous PRP. This study reported a significant improvement of mean VAS at 3 months without any serious side effects, and without the development of tumors.…”

Section: Clinical Evidencementioning

confidence: 99%

Adipose-Based Therapies for Knee Pain—Fat or Fiction

et al. 2018

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Regenerative cell therapies are emerging as promising treatments for numerous musculoskeletal conditions, including knee osteoarthritis (OA). Adipose-derived stem cells and possibly other adipose-based therapies have a greater chondrogenic potential than stem cells derived from bone marrow, and thus a lot of attention is being placed on them as potential regenerative agents in the treatment of knee OA. Several types of adipose-based therapies have good basic science and preclinical data supporting their translation to human therapeutic intervention. Cultured, adipose-derived stem cells appear to be good source of bioactive cells with convenient accessibility, relative abundance, and well-documented regenerative capacity. Non-culture expanded adipose-based therapy, in the forms of stromal vascular fraction and most recently micronized adipose tissue (MAT), have been utilized in patients to treat OA and other cartilage abnormalities with encouraging preliminary data. These adipose-based therapies have shown a lot of therapeutic potential; however, because of the regulatory restrictions on enzymatic isolation and cell expansion, only MAT is currently available in clinical practice in the United States. While no serious adverse reactions have been reported, adipose-derived therapies also have the potential for adverse reactions including inflammation and infection. The current review provides an update on the latest research and presents this evidence on the therapeutic potential of adipose-based therapies in the treatment of knee OA.

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“…35 However, the efficacy of MSC therapy alone is still unknown because most studies were done with adjuvant therapy. 36 A systematic review done by Filardo et al indicates that the patients who may benefit the most from MSC include ones who are younger, with lower body mass indexes, smaller focal lesions, and are at earlier stages of disease. 29 Overall, most studies have concluded that there are minimal, nonspecific adverse effects associated with MSC including slight knee pain and joint effusion after injection that resolve with antiinflammatory medication.…”

Section: Stem Cell Therapymentioning

confidence: 99%

“…Of note, many indicate that past studies may be biased, there is variability in preparation methods including different cell sources, harvest sites, or delivery methods, there has been only short-term follow-up, and many studies have been done in combination with other therapies like PRP, HA, or arthroscopic lavage warranting further research. 29,33,36,38…”

Section: Stem Cell Therapymentioning

confidence: 99%

Minimally Invasive Interventional Management of Osteoarthritic Chronic Knee Pain

et al. 2018

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Chronic knee pain is a widely prevalent issue that can have a significant impact on a patient's quality of life. One of the leading causes of chronic knee pain is osteoarthritis. Total knee replacement is often the last and definitive resort for patients with severe symptomatic osteoarthritis after trial of less invasive interventions with failure to achieve symptomatic relief. Intra-articular injections are a mainstay of adjunctive conservative management and have demonstrated efficacy in reducing pain. Radiofrequency treatment is a viable option for poor surgical candidates, or for patients having persistent, chronic pain following knee surgery. Extracorporeal shockwave therapy is another modality growing in use that may offer short-term symptomatic relief. In this review, we will discuss widely used minimally invasive interventional options for the symptomatic management of osteoarthritic chronic knee pain.

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Limited evidence for adipose-derived stem cell therapy on the treatment of osteoarthritis

Abstract: Level IV, systematic review of level IV studies.

Cited by 59 publications

References 44 publications

Designer Stem Cells: Genome Engineering and the Next Generation of Cell‐Based Therapies

Designer Stem Cells: Genome Engineering and the Next Generation of Cell‐Based Therapies

Adipose-Based Therapies for Knee Pain—Fat or Fiction

Minimally Invasive Interventional Management of Osteoarthritic Chronic Knee Pain

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