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. 2020 Sep 14;9(9):2096.
doi: 10.3390/cells9092096.

Treatment of Grade 3 and 4 Osteoarthritis with Intraoperatively Separated Adipose Tissue-Derived Stromal Vascular Fraction: A Comparative Case Series

Denis Simunec  1 , Honey Salari  1 , Juliane Meyer  2
Affiliations

Treatment of Grade 3 and 4 Osteoarthritis with Intraoperatively Separated Adipose Tissue-Derived Stromal Vascular Fraction: A Comparative Case Series

Denis Simunec et al. Cells. .

Abstract

Osteoarthritis (OA) is the most common form of arthritis of the joints. The stromal vascular fraction (SVF) is a regenerative cell population that can be isolated from adipose tissue. It is the immunomodulatory properties of the stromal vascular fraction that make it a promising candidate for the regenerative treatment of OA. Patients with grade 3 and 4 osteoarthritis were treated with the stromal vascular fraction with and without platelet-rich plasma (PRP) and followed up on their Knee Injury and Osteoarthritis Outcome Score (KOOS) score for 12 months, with MRI and subjective evaluation of the procedure. Magnetic resonance imaging (MRI) revealed a widening of the joint space, a restructuring of the cartilage, and an alleviation of effusions in the treated joints. In three of the four treatment groups, a substantial improvement of the KOOS scores was documented at the 12-month follow-up time point. According to the subjective evaluation, 67% of the patients were satisfied or very satisfied with the procedure and would recommend it to others. No serious adverse events or unwanted side effects related to the SVF treatment were observed or reported. Prior to an invasive artificial joint replacement, the treatment of arthritic knee joints with the intraarticular injection of autologous adipose tissue-derived SVF should be considered a regenerative treatment option.

Keywords: Q-graft®; adipose tissue-derived stem/stromal cells (ASCs); osteoarthritis (OA); stromal vascular fraction (SVF); therapeutics.

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Conflict of interest statement

Denis Simunec and Honey Salari have nothing to disclose. Juliane Meyer is an employee of Human Med AG. Products from this company were used in the study. All authors adhered to the Good Publication Practice guidelines for pharmaceutical companies.

Figures

Figure 1
Figure 1
Structuring of the study group. The study group consisted of 12 patients. Six of them had OA grade 3 on the Kellgren–Lawrence scale; 6 of them had OA grade 4. Within each group, 3 patients were treated with the SVF, and 3 patients were treated with the SVF and PRP. OA, osteoarthritis; SVF, stromal vascular fraction; PRP, platelet-rich plasma.
Figure 2
Figure 2
Separation system for regenerative cells from adipose tissue Q-graft® (Human Med AG, Schwerin, Germany) consisting of the disposable part Q-graft® collector (top) and the reusable control unit Q-graft® control (bottom).
Figure 3
Figure 3
Magnetic resonance imaging (MRI) status of the right knee joint before treatment with the SVF (left), showing lesion in the cartilage (red arrow) and 16 months after treatment with SVF (right), showing potential cartilage regeneration and disappearance of the effusion (green arrow).
Figure 4
Figure 4
Magnetic resonance imaging (MRI) status of the right knee joint before treatment with the SVF and PRP (left), showing a joint space of 5.1 mm at the saddle point and 3.6 mm in the medial area. At 14 months after treatment with the SVF and PRP (right), the joint space was 6.5 mm at the saddle point and 4.1 mm in the medial area.
Figure 5
Figure 5
Progression of the KOOS scores of the four treatment groups at baseline as well as 1, 3, 6, and 12 months after the treatment of knee osteoarthritis with freshly isolated SVF from the adipose tissue; n = 3 for each group at each time point; KOOS, Knee injury and Osteoarthritis Outcome Score. PRP, platelet-rich plasma.
Figure 6
Figure 6
Subjective evaluation of the 11 patients on their overall satisfaction with the SVF treatment of their knee osteoarthritis with freshly isolated SVF from the adipose tissue.
Figure 7
Figure 7
Subjective evaluation of the 11 patients on whether they would recommend the treatment of their knee osteoarthritis with freshly isolated SVF from the adipose tissue.
See this image and copyright information in PMC

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