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. 2021 Jan-Dec:30:9636897211067454.
doi: 10.1177/09636897211067454.

Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

Masanori Tsubosaka  1 , Tomoyuki Matsumoto  1 , Satoshi Sobajima  2 , Takehiko Matsushita  1 , Hideki Iwaguro  2 , Ryosuke Kuroda  1
Affiliations

Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis

Masanori Tsubosaka et al. Cell Transplant. 2021 Jan-Dec.

Abstract

Favorable clinical outcomes of intra-articular injection of adipose-derived stromal vascular fraction (SVF) cells for knee osteoarthritis (OA) have been reported, but the effects of different doses of SVF cells have not been examined. This study aimed to compare the short-term clinical and imaging outcomes of different doses of SVF cells for knee OA treatment. This study included 60 patients with knee OA who underwent intra-articular injection of SVF cells. The follow-up period was at least 12 months. Thirty patients received an intra-articular injection of 2.5×107 SVF cells (low-dose group), and the remaining 30 patients received an intra-articular injection of 5.0×107 SVF cells (high-dose group). Clinical evaluations were performed for the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, including the magnetic resonance imaging Osteoarthritis Knee Score (MOAKS) features (bone marrow lesions, cartilage defects, osteophytes, Hoffa's synovitis, and effusion synovitis), were also performed. All clinical and imaging evaluations were performed preoperatively and 12 months postoperatively and compared between the groups. In demographic data, no significant differences were found between the two groups. The total score of KOOS at 12 months postoperatively was significantly more favorable than the preoperative score in the high-dose groups. Pain and symptoms subscale scores of KOOS at 12 months postoperatively were significantly better in the high-dose group than in the low-dose group. The bone marrow lesions, Hoffa's synovitis, and effusion synovitis improved approximately 30-40% at 12 months postoperatively compared to baseline in both groups. However, there were no significant differences in imaging evaluations between the two groups. In conclusion, the pain and symptoms subscale scores of KOOS from baseline to 12 months postoperatively improved better in the high-dose group than in the low-dose group. Our findings suggest that intra-articular injection of SVF cells for knee OA is an innovative approach.

Keywords: adipose-derived stromal vascular fraction cells; dose-effect; magnetic resonance imaging osteoarthritis knee score; osteoarthritis; stem cell.

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Figures

Figure 1.
Figure 1.
Schema of treatment procedures.
Figure 2.
Figure 2.
Clinical evaluation results of range of motion and muscle force.
Figure 3.
Figure 3.
Results of visual analog scale for pain.
Figure 4.
Figure 4.
Results of Knee injury and Osteoarthritis Outcome Score.
Figure 5.
Figure 5.
(a) Imaging evaluation results of bone marrow lesions by magnetic resonance imaging Osteoarthritis Knee Score system. (b) Imaging evaluation results of cartilage defects by magnetic resonance imaging Osteoarthritis Knee Score system. (c) Imaging evaluation results of osteophytes by magnetic resonance imaging Osteoarthritis Knee Score system. (d) Imaging evaluation results of Hoffa’s synovitis and effusion synovitis by magnetic resonance imaging Osteoarthritis Knee Score system.
Figure 6.
Figure 6.
Representative cases of imaging evaluations. (a) Bone marrow lesion improved from Grade II to 0 before and after treatment. (b) Cartilage defects improved from Grade II to Grade 0 before and after treatment. (c) Hoffa’s synovitis improved from Grade I to 0 before and after treatment, and effusion synovitis also improved from Grade III to I before and after treatment.
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