Autologous and Allogenic Utilization of Stromal Vascular Fraction and Decellularized Extracellular Matrices in Orthopedic Surgery: A Scoping Review

Abstract

Background: This narrative review of the literature aims to analyze the utilization of stromal vascular fraction (SVF) and decellularized extracellular matrices (dECMs) in various pathologies related to orthopedic surgery.

Methods: A literature search was carried out in PubMed on February 15, 2022, using "Stroma Vascular Fraction and Orthopedic Surgery" and "Decellularized Extracellular Matrices and Orthopedic Surgery" as keywords. A total of 278 articles were found, of which 28 papers were selected because they seemed to be the most appropriate concerning the title of the article.

Results: The reported results have shown that intra-articular injection of SVF seems to be a safe and efficacious method for managing knee osteoarthritis (OA). Platelet-rich plasma (PRP) and SVF are safe and effective management for intractable Achilles tendinopathy in humans, although subjects treated with SVF recover earlier. There are promising results in utilizing adipose-derived mesenchymal stromal cells in chronic lateral epicondylitis of the elbow in athletes. Ready-to-use ECM/SVF gel seems to be a good therapeutic option promoting the regeneration of the articular cartilage in subjects with injuries of the cartilage. The SVF can safely be used to treat diabetic subjects suffering from chronic foot ulcers.

Conclusion: There are scarce high-quality data for utilizing cell-based approach in soft tissue injuries of the knee in athletes. Experimental studies indicate that SVF could be a new option to osseous regeneration. Other experimental studies support the utilization of dECMs as a scaffold for the regeneration of large osseous defects, cell-derived dECMs scaffolds to repair articular cartilage injuries, and utilization of xenogeneic acellular muscles to manage volumetric muscle loss where there is a lack of donor site.Intra-articular injections of SVF seems to be a safe and efficacious method for managing OA of the knee joint. Platelet-rich plasma (PRP) and SVF are safe and efficacious methods for the management of intractable Achilles tendinopathy in humans, although subjects treated with SVF recover earlier.

Keywords: Bone regeneration; Cartilage regeneration; Decellularized extracellular matrices; Osteoarthritis; Stromal vascular fraction; Tendon healing.

Figure 1

Transplantation into an osteoarthritic joint with adipose-derived stromal vascular fraction cells

Figure 2

Schematic diagram of the technique for preparing a decellularized extracellular matrix (dECM) scaffold for articular cartilage repair. ECM, extracellular matrix

Figure 3

Composite scaffold promotes the chondrogenic differentiation of seeded mesenchymal stem cells (MSCs). Schematic diagram of the technique for preparing composite scaffold composed of cell-derived decellularized extracellular matrix (dECM) and polymer materials. ECM, extracellular matrix