Management of knee osteoarthritis by combined stromal vascular fraction cell therapy, platelet-rich plasma, and musculoskeletal exercises: a case series

Abstract

IntroductionKnee osteoarthritis is associated with persistent joint pain, stiffness, joint deformities, ligament damage, and surrounding muscle atrophy. The complexity of the disease makes treatment difficult. There are no therapeutic drugs available to halt the disease progression, leaving patients dependent on pain medication, anti-inflammatory drugs, or invasive joint replacement surgery.Case presentationsFour patients with a history of unresolved symptomatic knee osteoarthritis were investigated for the therapeutic outcome of combining an exercise rehabilitation program with intra-articular injections of autologous StroMed (ie, stromal vascular fraction cells concentrated by ultrasonic cavitation from lipoaspirate) and platelet-rich plasma (PRP). The Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS) was administered along with physical function tests over a 12-month period. The first patient achieved a maximum therapeutic outcome of 100 in all five KOOS subscales (left knee), and 100 for four subscales (right knee). The second patient scored 100 in all five KOOS subscales (left knee), and greater than 84 in all subscales (right knee). Treatment of the third patient resulted in improved outcomes in both knees of >93 for four KOOS subscales, and 60 for the Function in Sport and Recreation subscale. The fourth patient improved to 100 in all five KOOS subscales. In all patients, the physical function “Get-up and Go” test and “Stair Climbing Test” returned to normal (a value of zero).ConclusionThis case series indicates that improved outcomes may be obtained when autologous stromal vascular fraction (StroMed) cell therapy is combined with traditional exercise practices and PRP for osteoarthritis. Of the seven joints treated: all patients’ scores of pain improved to >96; and quality of life scores to >93. Functional performance measures of mobility returned to normal. This simple treatment appears to be extremely effective for osteoarthritis disorders that have no drug treatment to halt disease progression.

Concise Review: Using Fat to Fight Disease: A Systematic Review of Nonhomologous Adipose-Derived Stromal/Stem Cell Therapies

“…Patients have experienced improvements in pain, function, mobility, and overall quality of life on various clinical questionnaires after SVF and ASC administration into the affected joints (Fig. H) . Clinical improvement persisted in these studies for several months to more than two years.…”

Regenerative medicine for advanced surgical care

“…The ability of MSCs to upregulate T regulatory cells, migrate to sites of inflammation, and dampen immune responses by suppressing proinflammatory cytokines underscores why reported healing rates are between 50 and 83 percent. This safety profile and treatment success pave the way for the translation of cellular properties into bedside efficacy, with the potential for widespread adoption, as has been observed with CAR T cell therapy for lymphoma and stromal vascular fraction for osteoarthritis.…”

Concise Review: The Use of Adipose-Derived Stromal Vascular Fraction Cells and Platelet Rich Plasma in Regenerative Plastic Surgery

“…As concerning osteoarticular pathology, Pak et al reported at present no cure for painful osteoarthritis in stages 2 and 3. For these patients, the intra‐articular injection of ASCs contained in the SVF can be an effective treatment option.…”