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. 2017 Jun 19;15(1):141.
doi: 10.1186/s12967-017-1242-4.

Intra-articular Injection in the Knee of Adipose Derived Stromal Cells (Stromal Vascular Fraction) and Platelet Rich Plasma for Osteoarthritis

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Free PMC article

Intra-articular Injection in the Knee of Adipose Derived Stromal Cells (Stromal Vascular Fraction) and Platelet Rich Plasma for Osteoarthritis

Himanshu Bansal et al. J Transl Med. .
Free PMC article

Abstract

Background: Stromal 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.

Methods: A 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.

Results: The 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.

Conclusions: Overall, 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.

Keywords: Adipose derived stromal/stem cells (ADSCs); Adipose tissue; Cell therapy; Connective tissue; Osteoarthritis; Platelet rich plasma (PRP); Stem cells; Stromal vascular fraction (SVF).

Figures

Fig. 1
Fig. 1
a Morphology of the fat derived MSC. b Flow cytometry analysis of MSC using BD FACS calibur
Fig. 2
Fig. 2
a Total WOMAC score. b WOMAC pain score. c WOMAC stiffness score. d WOMAC physical function score
Fig. 3
Fig. 3
Six minute walk distance (6MWD)
Fig. 4
Fig. 4
MRI a baseline, b 2 years post injection. Improvement of 0.2 mm at posterior condyle/meniscus sites
Fig. 5
Fig. 5
MRI a baseline, b 12 months post injection. Improvement of 0.2 mm at meniscus and patellar
Fig. 6
Fig. 6
MRI a baseline, b 12 months post injection. Improvement of 0.2 mm at posterior and meniscus. No changes noted at patella/femoral level
Fig. 7
Fig. 7
MRI a baseline, b 12 months post injection. Improvement of 0.2 mm at posterior level. No changes noted in anterior level or meniscus
Fig. 8
Fig. 8
MRI a baseline, b 12 months post injection. Improvement at all levels

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