RETRACTED ARTICLE: Intra-articular injection in the knee of adipose derived stromal cells (stromal vascular fraction) and platelet rich plasma for osteoarthritis

Abstract

BackgroundStromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue and platelet rich plasma (PRP) can be obtained from peripheral blood. We evaluated the safety and preliminary efficacy of administering SVF and PRP intra-articularly into patients with osteoarthritis grade 1 and 2.MethodsA total of ten patients underwent a local tumescent liposuction procedure to remove approximately 100 ml of fat tissue from the abdomen. SVF was isolated using an enzyme digestion and resuspended in PRP for intra-articular injection in the knee. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and six-minute walk distance (6MWD) were used to evaluate clinical effects and included measure of patient’s subjective assessment of pain, joint mobility, and physical disability. WOMAC score, 6MWD and laboratory tests were repeated at 3 and 6 months and 1, 1.5 and 2 years. XRAY and MRI were completed at 1 year.ResultsThe average total WOMAC score was 64 at baseline and significantly reduced to 52 at 3 months, 46 at 6 months, 42 at 1 year, 38 at 1.5 years, and 41 at 2 years. Patients walked an average of 1310 feet at baseline and demonstrated a statistically significant improvement at 3 and 6 months and 1, 1.5, and 2 years post treatment. Cartilage thickness as determined by MRI improved by at least 0.2 mm in six patients, was unchanged in two patients and decreased by at least 0.2 mm in two patients.ConclusionsOverall, all of the patients were pleased with the treatment results. They reported a reduction in pain levels, especially after 3 months. More importantly, the procedure demonstrated a strong safety profile with no severe adverse events or complications reported. Trial registration NCT03089762; Name of registry: http://www.clinicaltrials.gov

Secreted Factors and EV-miRNAs Orchestrate the Healing Capacity of Adipose Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis

“…In particular, increased action of the matrix metalloproteinases (MMPs) in combination with reduction of their inhibitors (TIMPs) levels are largely responsible for the earliest osteoarthritic changes [60], suggesting that a restoration of the healthy balance would help in residual cartilage protection and regeneration. Interestingly, in pioneering studies on OA patients, SVF injection was able to stimulate partial regeneration of the articular cartilage, as described by positive changes in the imaging outcomes (MRI or CT) [61][62][63][64][65]. Consistently, in the last years, few clinical trials based on intra-articular injection of autologous ASCs in OA joints reported improvement in pain, function and cartilage volume [66,67].…”

Regenerative Sports Medicine: Past, Present, and Future (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)

“…In summary, there are no level I studies evaluating micro-fragmented adipose tissue for musculoskeletal disorders. The only randomized studies currently available evaluate the stromal vascular fraction or the culture-expanded adipose-derived product, which are not currently approved for use in orthopedic applications in the United States (Table 4) [132][133][134][135][136][137][138][139][140].…”

Injection of Stromal Vascular Fraction Plus Platelet-Rich Plasma in a Non-Healing Decubitus Ulcer

“…Comella et al reported on the safety of SVF in a variety of indications with various delivery methods. Other publications have demonstrated success of SVF for specific conditions including: chronic obstructive pulmonary disease (COPD) [17], congestive heart failure [18], degenerative disc disease [19], osteoarthritis/orthopedics [20][21][22][23][24], radiation necrosis [25], sclerosis [26], tendinopathy [27], xerostomia [28], psoriasis [29] and multiple sclerosis [30]. The following is a case report and to our knowledge first in man a single injection of SVF and PRP into a chronic non-healing stage 3 ulcer in a patient with an incomplete spinal cord injury.…”