Knee Osteoarthritis Treatment – Effect of Adipose-derived Stromal Vascular Fraction Cells
Osteoarthritis is a chronic degenerative joint disorder characterized by the destruction of articular cartilage and the formation of osteophyte. OA is also a prevalent cause of disability among the elderly, where 10–50% of the senior population in the United States is affected by it, while there are many who are severely disabled. Knee OA initiates changes in the tendons, ligaments, and muscles of the knee joint, leading to poor psychosocial outcomes, knee buckling, balance deficits, increased risk of falls, and limitation in certain physical activities. The type of difficulty can decrease the quality of life.
Recently, Adipose-derived Stromal Vascular Fraction Cell therapy has been getting significant attention and considered a less invasive yet more effective therapy procedure for knee OA. The ADSC therapy shares a few common characteristics as the bone marrow-derived mesenchymal stem cells (BMSCs), but collecting stem cells from bone marrow is relatively easier and offers higher isolation yields. Compared to BMSCs, ADSC takes a relatively long time for culturing. The time span could range between a couple of weeks to a month between isolation and application.
Studies show that Adipose-derived stromal vascular fraction (SVF) cells contain regenerative cells such as fibroblasts, pericytes, blood cells, macrophages, ADSCs, and vessel-forming cells like endothelial and smooth muscle cells. Stromal Vascular Fraction Cells can be isolated easily in large amounts from the autologous adipose tissue and can be used without differentiation or culturing. Fodor et al. reported that autologous adipose-derived SVF cells were safe and presented a new potential therapy for pain reduction in knee OA. Hong et al. reported that SVF cell treatment could be more effective than treatment with hyaluronic acid, although their sample size was small.
The efficacy and safety of SVF cells have been examined in multiple different clinical settings such as urology, reconstructive surgery, cardiology, and plastic surgery. Studies have also reported that SVF is effective in orthopedic clinical settings. However, the detailed clinical evaluation of SVF cell treatment for knee OA while securing the sample size has not yet been reported in a large number of patients.
Based on the studies conducted, it was found that SVF cells help improve symptoms with conservative treatment, including medication, rehabilitation, and intra-articular injection of steroids and hyaluronic acid.
Tsubosaka, M., Matsumoto, T., Sobajima, S., Matsushita, T., Iwaguro, H., & Kuroda, R. (2020). The influence of adipose-derived stromal vascular fraction cells on the treatment of knee osteoarthritis. BMC musculoskeletal disorders, 21, 1-10.
Hong Z, Chen J, Zhang S, Zhao C, Bi M, Chen X, et al. Intra-articular injection of autologous adipose-derived stromal vascular fractions for knee osteoarthritis: a double-blind randomized self-controlled trial. Int Orthop. 2019;43:1123–34.