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Prizov A, Tchetina E, Volkov A, Eremin I, Zagorodniy N, Lazko F, Pulin A, Belyak E, Kotenko K, Eshmotova G, Glukhova S, Lila A. Long-Term Structural Changes in the Osteochondral Unit in Patients with Osteoarthritis Undergoing Corrective Osteotomy with Platelet-Rich Plasma or Stromal Vascular Fraction Post-Treatment. Biomedicines 2024; 12:1044. [PMID: 38791006 PMCID: PMC11118028 DOI: 10.3390/biomedicines12051044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
This pilot study examined the long-term structural changes in the osteochondral unit of 20 patients with knee osteoarthritis (KOA) who underwent high tibial osteotomy (HTO) and received post-treatment with either platelet-rich plasma (PRP) or stromal vascular fraction (SVF). Ten patients were injected with autologous PRP (PRP subgroup), while another ten patients received autologous SVF (SVF subgroup) six weeks after surgery and were monitored for 18 months. Histological samples of bone and cartilage (2 mm in diameter and 2 cm long) were taken from tibial and femoral sites during surgery and 18-month post-HTO, and morphometric analyses were conducted using Mega-Morf12 software. Both post-treatment resulted in an increase in articular cartilage height at both sites (p < 0.001 in the tibia and femur), indicating positive outcomes. Significant improvements in subchondral and trabecular bone architecture were also observed, with SVF injection showing higher reparative capacity in terms of bone volume (p < 0.001 for the tibia and p = 0.004 for the femur), subchondral bone height (p < 0.001 for the tibia and p = 0.014 for the femur), trabecular bone volume (p < 0.001 for the femur), and intertrabecular space (p = 0.009 for the tibia and p = 0.007 for the femur). This pilot study, for the first time, demonstrates that HTO surgery combined with PRP and SVF post-treatments can lead to significant enhancements in knee articular cartilage and bone architecture in KOA patients, with SVF showing higher regenerative potential. These findings may contribute to improving treatment strategies for better clinical outcomes in HTO therapy for patients with KOA.
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Affiliation(s)
- Aleksey Prizov
- Department of Traumatology and Orthopaedics, RUDN University, Miklukho-Maklaya Str. 6, Moscow 117198, Russia; (A.P.); (N.Z.); (F.L.); (E.B.)
| | - Elena Tchetina
- Immunology and Molecular Biology Laboratory, Nasonova Research Institute of Rheumatology, Kashirskoe Shosse 34A, Moscow 115522, Russia; (S.G.); (A.L.)
| | - Aleksey Volkov
- Department of Pathological Anatomy, RUDN University, Miklukho-Maklaya Str. 6, Moscow 117198, Russia; (A.V.); (G.E.)
- Laboratory of Bone Tissue Pathology, Research Institute of Human Morphology, n.a. akad A.P. Avtsyna, Petrovsky National Research Center of Surgery, Abrikosovsky lane 2, Moscow 119435, Russia
| | - Ilya Eremin
- Surgery Department, Petrovsky National Research Center of Surgery, Abrikosovsky lane 2, Moscow 119435, Russia; (I.E.); (K.K.)
| | - Nikolay Zagorodniy
- Department of Traumatology and Orthopaedics, RUDN University, Miklukho-Maklaya Str. 6, Moscow 117198, Russia; (A.P.); (N.Z.); (F.L.); (E.B.)
- National Medical Research Center of Traumatology and Orthopedics, n.a. N.N. Priorov, Priorova Str. 10, Moscow 127299, Russia
| | - Fedor Lazko
- Department of Traumatology and Orthopaedics, RUDN University, Miklukho-Maklaya Str. 6, Moscow 117198, Russia; (A.P.); (N.Z.); (F.L.); (E.B.)
| | - Andrey Pulin
- Pirogov National Medical and Surgical Center, Nizhnyaya Pervomayskaya Str. 70, Moscow 105203, Russia;
| | - Evgeniy Belyak
- Department of Traumatology and Orthopaedics, RUDN University, Miklukho-Maklaya Str. 6, Moscow 117198, Russia; (A.P.); (N.Z.); (F.L.); (E.B.)
| | - Konstantin Kotenko
- Surgery Department, Petrovsky National Research Center of Surgery, Abrikosovsky lane 2, Moscow 119435, Russia; (I.E.); (K.K.)
| | - Gulnora Eshmotova
- Department of Pathological Anatomy, RUDN University, Miklukho-Maklaya Str. 6, Moscow 117198, Russia; (A.V.); (G.E.)
| | - Svetlana Glukhova
- Immunology and Molecular Biology Laboratory, Nasonova Research Institute of Rheumatology, Kashirskoe Shosse 34A, Moscow 115522, Russia; (S.G.); (A.L.)
| | - Aleksandr Lila
- Immunology and Molecular Biology Laboratory, Nasonova Research Institute of Rheumatology, Kashirskoe Shosse 34A, Moscow 115522, Russia; (S.G.); (A.L.)
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Goncharov EN, Koval OA, Nikolaevich Bezuglov E, Encarnacion Ramirez MDJ, Engelgard M, Igorevich EI, Saporiti A, Valentinovich Kotenko K, Montemurro N. Stromal Vascular Fraction Therapy for Knee Osteoarthritis: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2090. [PMID: 38138193 PMCID: PMC10744886 DOI: 10.3390/medicina59122090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/22/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Knee osteoarthritis (OA) is a widespread joint disease, set to increase due to aging and rising obesity. Beyond cartilage degeneration, OA involves the entire joint, including the synovial fluid, bones, and surrounding muscles. Existing treatments, such as NSAIDs and corticosteroid injections, mainly alleviate symptoms but can have complications. Joint replacement surgeries are definitive but carry surgical risks and are not suitable for all. Stromal vascular fraction (SVF) therapy is a regenerative approach using cells from a patient's adipose tissue. SVF addresses as degenerative and inflammatory aspects, with potential for cartilage formation and tissue regeneration. Unlike traditional treatments, SVF may reverse OA changes. Being autologous, it reduces immunogenic risks. Materials and Methods: A systematic search was undertaken across PubMed, Medline, and Scopus for relevant studies published from 2017 to 2023. Keywords included "SVF", "Knee Osteoarthritis", and "Regenerative Medicine". Results: This systematic search yielded a total of 172 articles. After the removal of duplicates and an initial title and abstract screening, 94 full-text articles were assessed for eligibility. Of these, 22 studies met the inclusion criteria and were subsequently included in this review. Conclusions: This review of SVF therapy for knee OA suggests its potential therapeutic benefits. Most studies confirmed its safety and efficacy, and showed improved clinical outcomes and minimal adverse events. However, differences in study designs and sizes require a careful interpretation of the results. While evidence supports SVF's positive effects, understanding methodological limitations is key. Incorporating SVF is promising, but the approach should prioritize patient safety and rigorous research.
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Affiliation(s)
| | | | | | | | - Mikhail Engelgard
- Petrovsky Russian Scientific Center of Surgery, 121359 Moscow, Russia
| | | | - Alessandra Saporiti
- Department of Pharmaceuticals, Azienda Usl Toscana Nord Ovest, 56100 Pisa, Italy
| | | | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), 56100 Pisa, Italy
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Skvortsov D, Prizov A, Kaurkin S, Altukhova A, Zagorodniy N, Lazko F, Nikitin A. Gait analysis and knee kinematics before, and 6 and 18 months after corrective valgus osteotomy. Knee 2023; 41:1-8. [PMID: 36608358 DOI: 10.1016/j.knee.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/08/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The study objective was to assess clinical outcomes and gait biomechanics in patients after 6 and 18 months after varus deformity (VD) surgical correction at knee joint (KJ). METHOD The study included 20 patients with medial osteoarthritis (OA) of the knee of grade 2-3 and a VD of >4°. A total of 21 surgeries were performed on the patients. Full length weight bearing (FLWB) X-ray and KJ assessments were done using the KSS, KOOS and VAS scoring systems were obtained from all the patients. Biomechanical gait parameters were captured using an inertial sensor system at timepoints before, and 6 and 18 months after surgery. Temporal and kinematic parameters of walking were analyzed. RESULTS The radiological parameters showed a stable VD correction. According to the KOOS, KS and VAS scores, there was a moderate dynamic improvement in the operated knee function during the study. The biomechanical parameters remained virtually unchanged throughout the entire follow-up period. In the following year, there were some subjective improvements but without any significant changes in gait biomechanics or knee kinematics. CONCLUSIONS Thus, the main changes in the joint clinical condition and function occur in the first 6 months after surgery. According to the study data-assessments by VAS, KOOS, and KSS-there was a moderate clinical improvement during the long-term follow-up period, however, the biomechanical changes were minor.
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Affiliation(s)
- Dmitry Skvortsov
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Scientific Department, Orekhoviy bulvar, 28, 115682 Moscow, Russia; Pirogov Russian National Research Medical University (RNRMU), Medical Rehabilitation Chair, ul. Ostrovitianova, 1, 117997 Moscow, Russia.
| | - Alexey Prizov
- Buyanov V.M. Moscow City Clinical Hospital, Orthopedic Department, ul. Bakinskaya, 26, 115516 Moscow, Russia; Peoples Friendship University of Russia (RUDN University), Ortopedic Chair, ul. Miklukho-Maklaya, 6, 117198 Moscow, Russia.
| | - Sergey Kaurkin
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Scientific Department, Orekhoviy bulvar, 28, 115682 Moscow, Russia; Pirogov Russian National Research Medical University (RNRMU), Medical Rehabilitation Chair, ul. Ostrovitianova, 1, 117997 Moscow, Russia.
| | - Alyona Altukhova
- Federal Research and Clinical Centre of Russia's Federal Medical-Biological Agency (FNKC FMBA), Scientific Department, Orekhoviy bulvar, 28, 115682 Moscow, Russia.
| | - Nikolay Zagorodniy
- Buyanov V.M. Moscow City Clinical Hospital, Orthopedic Department, ul. Bakinskaya, 26, 115516 Moscow, Russia; National Medical Research Center of Traumatology and Orthopedics n.a. N.N. Priorov, ul. Priorova, 127299 Moscow, Russia.
| | - Fedor Lazko
- Buyanov V.M. Moscow City Clinical Hospital, Orthopedic Department, ul. Bakinskaya, 26, 115516 Moscow, Russia; Peoples Friendship University of Russia (RUDN University), Ortopedic Chair, ul. Miklukho-Maklaya, 6, 117198 Moscow, Russia.
| | - Artem Nikitin
- Buyanov V.M. Moscow City Clinical Hospital, Orthopedic Department, ul. Bakinskaya, 26, 115516 Moscow, Russia; Peoples Friendship University of Russia (RUDN University), Ortopedic Chair, ul. Miklukho-Maklaya, 6, 117198 Moscow, Russia.
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