Platelets and Adipose Stroma Combined for the Treatment of the Arthritic Knee

Abstract

Knee osteoarthritis (OA) leads to significant pain and disability, prompting new cell-based injections to lessen the symptoms. Biological therapies such as autologous microfragmented adipose tissue (AMAT) and a stromal vascular fraction (SVF) are a common source for harvesting mesenchymal and progenitor cells. Platelet-rich plasma (PRP) is associated with cytokines and growth factors. Recent studies have reported good clinical outcomes with AMAT, SVF, and PRP in knee osteoarthritis treatment. However, the preparation, processing, and application technique are vital to achieving satisfactory results. Many studies have examined outcomes after AMAT, SVF, or PRP injection, with encouraging results. Still, there is a lack of studies describing a technique that combines both methods, the timing, and the amount of SVF or PRP injected. This technical note's objective was to describe a standardized new technique composed of platelet and adipose stroma to treat knee osteoarthritis (OA) and the processing method. Autologous Adipose Tissue AspirationWith the patient in the prone position, under sedation, aseptic conditions, and local anesthesia (Fig 1, A and B), adipose tissue was harvested using a bilateral gluteus lipoaspiration approach (Fig 1C). The procedure

Arthroscopy with Lipoaspirate and Plasma Infiltration Using Adipose-Derived Stem Cells Plus Platelet-Rich Plasma: Harvesting and Injection for Arthroscopic Treatment of Cartilage Defects of the Knee

“…Dallo et al. 19 recently reported on the combination of PRP and adipose stroma to treat knee OA. They pointed out that the optimal use of stromal vascular fraction plus PRP has not yet been identified.…”

“… 3 , 17 , 18 Whereas PRP is known to be a source of growth factors and cytokines, adipose-derived tissue has more recently attracted attention as a possible source of adipose-derived stem cells (ASCs) and progenitor cells to repair cartilage defects. 19 , 20 , 21 The definitive pathways of cartilage regeneration induced by orthobiologic therapies are still discussed controversially and are a matter of ongoing research. 3 , 22 , 23 Nevertheless, recent studies have pointed out promising and easy-to-handle techniques to harness the beneficial effects of regenerative orthobiologic therapeutics.…”

Minimally Invasive Cell-Based Therapy for Symptomatic Bone Marrow Lesions of the Knee: A Prospective Clinical Study at 1 Year

“…Treating subchondral BMLs comprises both biological and structural components. Some biologic approaches like core decompression, autologous platelet-rich plasma (PRP) injections [24,25], adipose derivatives therapy [11,26], and bone marrow cell injections [27,28] are recently utilized.…”

Bio-Orthopedics: A New Approach to Osteoarthritis and Joint Disorders

“…After centrifugation the SVF fraction is retrieved. Lastly the SVF is combined with LP-PRP injected into the patient's knee joint (Figure 3) [25].…”