Adipose-derived stem cells in orthopaedic pathologies

Br Med Bull. 2017 Dec 1;124(1):31-54. doi: 10.1093/bmb/ldx030.

Abstract

Introduction: To examine the current literature regarding the clinical application of adipose-derived stem cells (ADSCs) for the management of orthopaedic pathologies.

Sources of data: MEDLINE,SCOPUS, CINAHL and EMBASE (1950 to April 14, 2017) were searched by two independent investigators for articles published in English. Reviews, meta-analyses, expert opinions, case reports, mini case series and editorials were excluded. Furthermore, we excluded animal studies, cadaveric studies and in vitro studies.

Areas of agreement: ADSCs seem to produce excellent clinical results. However, the length and modalities of follow-up in the different conditions are extremely variable. Nevertheless, it appears that the use of adipose-derived stem cells is associated with subjective and objective clinical improvements and minimal complication rates.

Areas of controversy: None of the studies identified is a randomized double-blinded trial, and most of the selected studies present major limitations, and different methods, confounding the results of our review.

Growing points: It is necessary to conduct more and better studies to ascertain whether ADSCs really play a role in orthopaedic surgery with particular attention to ADSCs harvesting method, type of administration and the conditions treated.

Areas timely for developing research: The current literature regarding the use of ADSCs for orthopaedic pathologies is limited. At present, long-term safety is the biggest challenge of ADSCs based regenerative medicine.

Level of evidence: Level IV-Study of Level I, II, III, IV.

Keywords: PRP; adipose-derived stem cells; injection; mesenchymal stem cells; regenerative medicine; scaffold; stromal vascular fraction.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / cytology*
  • Arthroscopy
  • Cells, Cultured
  • Guided Tissue Regeneration
  • Humans
  • Mesenchymal Stem Cells / cytology*
  • Musculoskeletal Diseases / therapy*
  • Orthopedics*
  • Regenerative Medicine*
  • Stem Cell Transplantation*
  • Tissue and Organ Harvesting / methods*