Intra-Articular Injection of Autologous Microfat and Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Comparative Study

Dumonceau, Robinson Gravier; Jouve, Élisabeth; Cohen, M.; Djouri, Rym; Richardet, Nathalie; Jourdan, Emmanuelle; Guy, Laurent; Dumoulin, Chloé; Grimaud, Fanny; Dignat-George, Françoise; Véran, Julie; Sabatier, Florence; Magalon, Jérémy

doi:10.1016/j.arthro.2021.03.074

Cited by 13 publications

(10 citation statements)

References 40 publications

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“…Results as objective as those reported in animals are difficult to reproduce in humans due to various ethical and practical concerns. Only a few clinical studies attempted to evaluate disease-modifying effects following injection of adipose-derived cell-based therapies in OA patients, including MFAT, SVF, and ASCs [61][62][63][64]. In this light, the analysis of the preclinical literature can help identify effects and mechanisms of action, as well as more promising strategies (e.g., number of cells, number of injections, preculturing, etc.).…”

Section: Discussionmentioning

confidence: 99%

Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies

Orfei

Boffa

Sourugeon

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of this systematic review was to determine if adipose tissue-derived cell-based injectable therapies can induce disease-modifying effects in joints affected by osteoarthritis (OA). Methods A systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical studies comparing injectable adipose-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE’s tool. Results Seventy-one studies were included (2,086 animals) with an increasing publication trend over time. Expanded cells were used in 65 studies, 3 studies applied point of care products, and 3 studies investigated both approaches. Overall, 48 out of 51 studies (94%) reported better results with adipose-derived products compared to OA controls, with positive findings in 17 out of 20 studies (85%) in macroscopic, in 37 out of 40 studies (93%) in histological, and in 22 out of 23 studies (96%) in immunohistochemical evaluations. Clinical and biomarker evaluations showed positive results in 14 studies out of 18 (78%) and 12 studies out of 14 (86%), while only 9 studies out of 17 (53%) of the imaging evaluations were able to detect differences versus controls. The risk of bias was low in 38% of items, unclear in 51%, and high in (11%). Conclusion The current preclinical models document consistent evidence of disease-modifying effects of adipose-derived cell-based therapies for the treatment of OA. The high heterogeneity of the published studies highlights the need for further targeted research to provide recommendations on the optimal methodologies for a more effective application of these injective therapies for the treatment of OA in clinical practice. Level of evidence II. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies

Orfei

Boffa

Sourugeon

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…As a precaution, we treated these patients with antibiotics after medical advice from infectious disease specialists. Although this aspect raises concerns about patient safety, this type of contamination has been previously described by Louis et al also using MF (4/30 products) and Garza et al using SVF (2/26 products) [ 52 , 53 ]. None of these events were associated with clinical infections.…”

Section: Discussionmentioning

confidence: 93%

Intra Articular Injection of Autologous Microfat and Platelets-Rich Plasma in the Treatment of Wrist Osteoarthritis: A Pilot Study

Mayoly

Witters

Jouve

et al. 2022

JCM

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No injection treatment has been proven to be effective in wrist osteoarthritis. When conservative measures fail, its management involves invasive surgery. Emergence of biotherapies based on adipose derived stem cells (ADSC) offers promising treatments for chondral degenerative diseases. Microfat (MF) and platelets-rich plasma (PRP) mixture, rich in growth factors and ADSC could be a minimally invasive injectable option in the treatment of wrist osteoarthritis. The aim of this uncontrolled prospective study was to evaluate the safety of a 4 mL autologous MF-PRP intra-articular injection, performed under local anesthesia. The secondary purpose was to describe the clinical and MRI results at 12 months of follow-up. Patients’ data collected were: occurrence of adverse effects, Visual analog scale (VAS), Disabilities of the Arm, Shoulder and Hand score (DASH) and Patient-Rated Wrist Evaluation (PRWE) scores, wrist strength, wrist range of motion and 5-level satisfaction scale. No serious adverse event was recorded. A statistically significant decrease in pain, DASH, PRWE and force was observed at each follow-up. Our preliminary results suggest that intra-articular autologous MF and PRP injection may be a new therapeutic strategy for wrist osteoarthritis resistant to medical symptomatic treatment prior to surgical interventions.

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“…In a prospective cohort study of Louis et al, 113 30 patients were randomly divided into 3 groups with injections microfat (MF)+ Saline, MF+ Low Dose PRP (PRP LD, 1000*10 9 /L), or MF+ High Dose PRP (PRP HD, 3000*10 9 /L). All treatments were effective in improving knee functional status and reducing symptoms, with significant reductions in all scores observed at 6 months.…”

Section: Resultsmentioning

confidence: 99%

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review

Liang

Wang

et al. 2022

CARTILAGE

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Objective This paper reviews the research of platelet-rich plasma (PRP) in articular cartilage injury repair, to assess the mechanism, utilization, and efficacy of PRP in the treatment of articular cartilage injury, hoping to provide a theoretical basis for the clinical application of PRP in the future. Materials and Methods A comprehensive database search on PRP applications in cartilage repair was performed. Among them, the retrieval time range of PRP in clinical trials of repairing knee cartilage injury was from January 1, 2021 to January 1, 2022. Non-clinical trials and studies unrelated to cartilage injury were excluded. Result PRP can affect inflammation, angiogenesis, cartilage protection, and cellular proliferation and differentiation after articular cartilage injury through different pathways. In all, 13 clinical trials were included in the analysis. Conclusion PRP is an emergent therapeutic approach in tissue engineering. Most studies reported that PRP has a positive effect on cartilage injury, improving the joint function, meanwhile there is a lack of standardized standards. The technology of PRP in the repair and treatment of articular cartilage injury is worthy of further research.

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Intra-Articular Injection of Autologous Microfat and Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Comparative Study

Cited by 13 publications

References 40 publications

Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies

Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies

Intra Articular Injection of Autologous Microfat and Platelets-Rich Plasma in the Treatment of Wrist Osteoarthritis: A Pilot Study

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review

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