Mid-term prognosis of the stromal vascular fraction for knee osteoarthritis: a minimum 5-year follow-up study

Abstract

Background The short-term safety and efficacy of stromal vascular fraction (SVF) in treating knee osteoarthritis (KOA) have been extensively studied but the mid-term and long-term prognoses remain unknown. Methods 126 KOA patients were recruited and randomly assigned to SVF group and hyaluronic acid (HA) group (control group). The scores of visual analogue scale (VAS) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were assessed and compared between the two groups 1, 2, 3, and 5 years after treatment. The endpoint was defined as surgeries related to KOA or clinical scores exceeding the patient acceptable symptom state (PASS). Results The VAS and WOMAC scores in the SVF group were significantly better than those in the HA group during the 5-year follow-up after treatment. The average responsive time to SVF treatment (61.52 months) was significantly longer than HA treatment (30.37 months). The adjusted Cox proportional hazards model showed that bone marrow lesion (BML) severity, body mass index (BMI) and treatment were independent risk factors and that the use of SVF reduced the risk of clinical failure by 2.602 times. The cartilage volume was reduced in both the SVF and control groups at 5 years but reduced less in the SVF group. Conclusions Up to 5 years after SVF treatment, acceptable clinical state was present for approximately 60% of patients. BML severity and BMI were independent predictors of the prognosis. Trial Registry: This study was retrospectively registered at Chinses Clinical Trial Registry with identifier ChiCTR2100052818 and was approved by ethics committee of the First Affiliated Hospital of Zhejiang Chinese Medical University, number 2013-X-063.

Molecular Characterization of Secreted Factors and Extracellular Vesicles-Embedded miRNAs from Bone Marrow-Derived Mesenchymal Stromal Cells in Presence of Synovial Fluid from Osteoarthritis Patients

“…For this reason, treatments that may reduce disease manifestation in addition to slowing or stopping its progression are actively sought. In this frame, mesenchymal stromal cells (MSCs) have emerged as an attractive option, both as GMP-grade products [ 13 ] and as point-of-care products [ 14 ] such as bone marrow aspirate concentrate (BMAC) [ 15 ], micro-fragmented adipose tissue (MFAT) [ 16 ] or stromal vascular fraction (SVF) [ 17 ].…”

Midterm results of intra‐articular stromal vascular fraction injection for the treatment of knee osteoarthritis

“…However, no study had a longer follow‐up, except for one study. Zhang et al [29] in a retrospective study compared the effects of SVF (56 knees) and HA (70 knees) injections on VAS and WOMAC scores and cartilage thickness over a 5‐year follow‐up period in 126 osteoarthritic knees. They reported a significant reduction in cartilage thickness in both injections, but less cartilage loss in the SVF group, and 60% of patients who received SVF injection at 5 years were clinically satisfied.…”

An update on the effect of intra-articular intervention strategies using nanomaterials in osteoarthritis: Possible clinical application

“…In recent years, some studies have showed the short and mid-term results of SVF for KOA, displaying their joint function improvement and analgesic effect ( Hong et al, 2019 ; Tran et al, 2019 ; Garza et al, 2020 ). Zhang et al (2022) conducted a medium-term study on SVF treatment in KOA patients. The results showed that up to 5 years after SVF treatment, almost 60% of patients had an acceptable clinical status ( Aubourg et al, 2021 ; Xiao et al, 2022 ).…”