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Courties A, Kouki I, Soliman N, Mathieu S, Sellam J. Osteoarthritis year in review 2024: Epidemiology and therapy. Osteoarthritis Cartilage 2024:S1063-4584(24)01320-7. [PMID: 39103081 DOI: 10.1016/j.joca.2024.07.014] [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: 06/17/2024] [Revised: 07/24/2024] [Accepted: 07/24/2024] [Indexed: 08/07/2024]
Abstract
This "Year in Review" presents a curated selection of research themes and individual studies within the clinical osteoarthritis (OA) field, focusing on epidemiology and therapy. The search was conducted in electronic database MEDLINE from March 4, 2023, to March 31, 2024, specifically targeting English-language articles involving human participants. Inclusions were based on perceived importance and relevance to identifying risk factors or advancing OA treatments. A total of 6539 studies were screened by the 5 authors, resulting in 157 studies considered for potential inclusion. Ultimately, 44 studies were selected, uncovering six key OA-related themes: i) the burden of OA (mostly from Global Burden of Disease studies), ii) pain drivers and trajectories, iii) impacts of sex/gender, iv) OA risk factors, and treatments for v) hand and vi) knee OA. The prevalence of OA continues to rise, particularly affecting women, with unclear distinctions in risk factors and treatment responses between sexes. Associations with atopy were demonstrated in two significant databases. Notably, the authors were particularly interested in recent high-quality methodology randomized controlled trials focusing on hand (methotrexate, denosumab, colchicine, topical betamethasone) and knee OA with conflicting results about stem cell injection. These findings collectively contribute to show the growing burden of OA, but also to help the understanding of OA pathophysiology and inform ongoing efforts to enhance management for people with OA.
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Affiliation(s)
- Alice Courties
- APHP, Hôpital Saint-Antoine, Service de Rhumatologie, Paris, France; Sorbonne Université, INSERM UMRS 938, Centre de Recherche Saint-Antoine (CRSA), Paris, France.
| | - Inès Kouki
- APHP, Hôpital Saint-Antoine, Service de Rhumatologie, Paris, France; Sorbonne Université, INSERM UMRS 938, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Nadine Soliman
- Sorbonne Université, INSERM UMRS 938, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Sylvain Mathieu
- Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Jérémie Sellam
- APHP, Hôpital Saint-Antoine, Service de Rhumatologie, Paris, France; Sorbonne Université, INSERM UMRS 938, Centre de Recherche Saint-Antoine (CRSA), Paris, France
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Ruoss S, Nasamran CA, Ball ST, Chen JL, Halter KN, Bruno KA, Whisenant TC, Parekh JN, Dorn SN, Esparza MC, Bremner SN, Fisch KM, Engler AJ, Ward SR. Comparative single-cell transcriptional and proteomic atlas of clinical-grade injectable mesenchymal source tissues. SCIENCE ADVANCES 2024; 10:eadn2831. [PMID: 38996032 PMCID: PMC11244553 DOI: 10.1126/sciadv.adn2831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/06/2024] [Indexed: 07/14/2024]
Abstract
Bone marrow aspirate concentrate (BMAC) and adipose-derived stromal vascular fraction (ADSVF) are the most marketed stem cell therapies to treat a variety of conditions in the general population and elite athletes. Both tissues have been used interchangeably clinically even though their detailed composition, heterogeneity, and mechanisms of action have neither been rigorously inventoried nor compared. This lack of information has prevented investigations into ideal dosages and has facilitated anecdata and misinformation. Here, we analyzed single-cell transcriptomes, proteomes, and flow cytometry profiles from paired clinical-grade BMAC and ADSVF. This comparative transcriptional atlas challenges the prevalent notion that there is one therapeutic cell type present in both tissues. We also provide data of surface markers that may enable isolation and investigation of cell (sub)populations. Furthermore, the proteome atlas highlights intertissue and interpatient heterogeneity of injected proteins with potentially regenerative or immunomodulatory capacities. An interactive webtool is available online.
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Affiliation(s)
- Severin Ruoss
- Department of Orthopaedic Surgery, UC San Diego, La Jolla, CA, USA
| | - Chanond A. Nasamran
- Center for Computational Biology and Bioinformatics, UC San Diego, La Jolla, CA, USA
| | - Scott T. Ball
- Department of Orthopaedic Surgery, UC San Diego, La Jolla, CA, USA
| | - Jeffrey L. Chen
- Department of Anesthesiology, Center for Pain, UC San Diego, La Jolla, CA, USA
| | - Kenneth N. Halter
- Department of Anesthesiology, Center for Pain, UC San Diego, La Jolla, CA, USA
| | - Kelly A. Bruno
- Department of Anesthesiology, Center for Pain, UC San Diego, La Jolla, CA, USA
| | - Thomas C. Whisenant
- Center for Computational Biology and Bioinformatics, UC San Diego, La Jolla, CA, USA
| | - Jesal N. Parekh
- Department of Orthopaedic Surgery, UC San Diego, La Jolla, CA, USA
| | - Shanelle N. Dorn
- Department of Orthopaedic Surgery, UC San Diego, La Jolla, CA, USA
| | - Mary C. Esparza
- Department of Orthopaedic Surgery, UC San Diego, La Jolla, CA, USA
| | | | - Kathleen M. Fisch
- Center for Computational Biology and Bioinformatics, UC San Diego, La Jolla, CA, USA
- Department of Obstetrics, Gynecology & Reproductive Sciences, UC San Diego, La Jolla, CA, USA
| | - Adam J. Engler
- Chien-Lay Department of Bioengineering, UC San Diego, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Samuel R. Ward
- Department of Orthopaedic Surgery, UC San Diego, La Jolla, CA, USA
- Chien-Lay Department of Bioengineering, UC San Diego, La Jolla, CA, USA
- Department of Radiology, UC San Diego, La Jolla, CA, USA
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Marquez-Curtis LA, Elliott JAW. Mesenchymal stromal cells derived from various tissues: Biological, clinical and cryopreservation aspects: Update from 2015 review. Cryobiology 2024; 115:104856. [PMID: 38340887 DOI: 10.1016/j.cryobiol.2024.104856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
Mesenchymal stromal cells (MSCs) have become one of the most investigated and applied cells for cellular therapy and regenerative medicine. In this update of our review published in 2015, we show that studies continue to abound regarding the characterization of MSCs to distinguish them from other similar cell types, the discovery of new tissue sources of MSCs, and the confirmation of their properties and functions that render them suitable as a therapeutic. Because cryopreservation is widely recognized as the only technology that would enable the on-demand availability of MSCs, here we show that although the traditional method of cryopreserving cells by slow cooling in the presence of 10% dimethyl sulfoxide (Me2SO) continues to be used by many, several novel MSC cryopreservation approaches have emerged. As in our previous review, we conclude from these recent reports that viable and functional MSCs from diverse tissues can be recovered after cryopreservation using a variety of cryoprotectants, freezing protocols, storage temperatures, and periods of storage. We also show that for logistical reasons there are now more studies devoted to the cryopreservation of tissues from which MSCs are derived. A new topic included in this review covers the application in COVID-19 of MSCs arising from their immunomodulatory and antiviral properties. Due to the inherent heterogeneity in MSC populations from different sources there is still no standardized procedure for their isolation, identification, functional characterization, cryopreservation, and route of administration, and not likely to be a "one-size-fits-all" approach in their applications in cell-based therapy and regenerative medicine.
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Affiliation(s)
- Leah A Marquez-Curtis
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB, Canada, T6G 1H9; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada, T6G 1C9
| | - Janet A W Elliott
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB, Canada, T6G 1H9; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada, T6G 1C9.
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Arias-Vázquez PI. Intra-articular Injections for Treating Knee Osteoarthritis: A Classification According to Their Mechanism of Action. J Clin Rheumatol 2024; 30:168-174. [PMID: 38595298 DOI: 10.1097/rhu.0000000000002080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Affiliation(s)
- Pedro Iván Arias-Vázquez
- From the MD Rehabilitation Medicine, Sports Medicine, Department of Rehabilitation, Universidad Juárez Autónoma de Tabasco, Comalcalco, México
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Holzbauer M, Priglinger E, Kølle SFT, Prantl L, Stadler C, Winkler PW, Gotterbarm T, Duscher D. Intra-Articular Application of Autologous, Fat-Derived Orthobiologics in the Treatment of Knee Osteoarthritis: A Systematic Review. Cells 2024; 13:750. [PMID: 38727286 PMCID: PMC11083621 DOI: 10.3390/cells13090750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of this study was to review the current literature regarding the effects of intra-articularly applied, fat-derived orthobiologics (FDO) in the treatment of primary knee osteoarthritis over a mid-term follow-up period. A systematic literature search was conducted on the online databases of Scopus, PubMed, Ovid MEDLINE, and Cochrane Library. Studies investigating intra-articularly applied FDO with a minimum number of 10 knee osteoarthritis patients, a follow-up period of at least 2 years, and at least 1 reported functional parameter (pain level or Patient-Reported Outcome Measures) were included. Exclusion criteria encompassed focal chondral defects and techniques including additional arthroscopic bone marrow stimulation. In 28 of 29 studies, FDO showed a subjective improvement in symptoms (pain and Patient-Reported Outcome Measures) up to a maximum follow-up of 7.2 years. Radiographic cartilage regeneration up to 3 years postoperatively, as well as macroscopic cartilage regeneration investigated via second-look arthroscopy, may corroborate the favorable clinical findings in patients with knee osteoarthritis. The methodological heterogeneity in FDO treatments leads to variations in cell composition and represents a limitation in the current state of knowledge. However, this systematic review suggests that FDO injection leads to beneficial mid-term results including symptom reduction and preservation of the affected joint in knee osteoarthritis patients.
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Affiliation(s)
- Matthias Holzbauer
- Department for Orthopedics and Trauma Surgery, Med Campus III, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; (E.P.); (C.S.); (P.W.W.); (T.G.)
- Faculty of Medicine, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Eleni Priglinger
- Department for Orthopedics and Trauma Surgery, Med Campus III, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; (E.P.); (C.S.); (P.W.W.); (T.G.)
- Faculty of Medicine, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | | | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany; (L.P.); (D.D.)
| | - Christian Stadler
- Department for Orthopedics and Trauma Surgery, Med Campus III, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; (E.P.); (C.S.); (P.W.W.); (T.G.)
- Faculty of Medicine, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Philipp Wilhelm Winkler
- Department for Orthopedics and Trauma Surgery, Med Campus III, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; (E.P.); (C.S.); (P.W.W.); (T.G.)
- Faculty of Medicine, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Tobias Gotterbarm
- Department for Orthopedics and Trauma Surgery, Med Campus III, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria; (E.P.); (C.S.); (P.W.W.); (T.G.)
- Faculty of Medicine, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria
| | - Dominik Duscher
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany; (L.P.); (D.D.)
- TF Plastic Surgery and Longevity Center, Herzogstrasse 67, 80803 Munich, Germany and Dorotheergasse 12, 1010 Vienna, Austria
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Adam AO, Benea HRC, Fotescu HM, Alcalá Ruiz M, Cimpean GC, Ciornei V, Cernacovschi A, Edves AR, Crisan M. Recent Trends in Adipose Tissue-Derived Injectable Therapies for Osteoarthritis: A Scoping Review of Animal Models. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:707. [PMID: 38792890 PMCID: PMC11123108 DOI: 10.3390/medicina60050707] [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: 02/01/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: This scoping review investigates recent trends in adipose tissue-derived injectable therapies for osteoarthritis (OA) in animal models, focusing on minimally manipulated or lightly processed adipose tissue. By evaluating and examining the specific context in which these therapies were investigated across diverse animal OA models, this review aims to provide valuable insights that will inform and guide future research and clinical applications in the ongoing pursuit of effective treatments for osteoarthritis. Materials and Methods: This research conducted a comprehensive literature review of PubMed and Embase to determine studies about minimally manipulated adipose tissue-derived injectable therapies for osteoarthritis investigated using animal models. The primary search found 530 results. After excluding articles that focused on spontaneous osteoarthritis; on transfected, preconditioned, cultured, or co-cultured adipose-derived stem cells; and articles with unavailable full text, we included 11 articles in our review. Results: The examined therapies encompassed mechanical micro-fragmented adipose tissue (MFAT) and stromal vascular fraction (SVF) obtained via collagenase digestion and centrifugation. These interventions were evaluated across various animal models, including mice, rats, rabbits, and sheep with induced OA. Notably, more studies concentrated on surgically induced OA rather than chemically induced OA. The assessment of these therapies focused on elucidating their protective immunomodulatory, anti-inflammatory, and chondroregenerative potential through comprehensive evaluations, including macroscopic assessments, histological analyses, immunohistochemical examinations, and biochemical assays. Conclusions: This review provides a comprehensive analysis of adipose tissue-derived injectable therapies for osteoarthritis across diverse animal models. While revealing potential benefits and insights, the heterogeneity of data and the limited number of studies highlight the need for further research to formulate conclusive recommendations for clinical applications.
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Affiliation(s)
- Alina Otilia Adam
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - Horea Rares Ciprian Benea
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - Horia Mihnea Fotescu
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Miriam Alcalá Ruiz
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - George Claudiu Cimpean
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - Vladimir Ciornei
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - Arsenii Cernacovschi
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - Andrei Rares Edves
- Department of Orthopedics and Traumatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400132 Cluj-Napoca, Romania; (A.O.A.)
| | - Maria Crisan
- Department of Histology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
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Schipper JAM, Tuin AJ, van Dongen JA, van Bakelen NB, Harmsen MC, Spijkervet FKL. Intra-Articular Injection of Adipose-Derived Stromal Vascular Fraction in Osteoarthritic Temporomandibular Joints: Study Design of a Randomized Controlled Clinical Trial. Bioengineering (Basel) 2024; 11:171. [PMID: 38391657 PMCID: PMC10886020 DOI: 10.3390/bioengineering11020171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease of the TMJ. It is characterized by progressive degradation of the extracellular matrix components of articular cartilage, with secondary inflammatory components leading to pain in the temporomandibular region and reduced mouth opening. Current treatments do not halt disease progression, hence the need for new therapies to reduce inflammation and, consequently, improve symptoms. The aim of our randomized controlled clinical trial protocol is to investigate the efficacy of adjuvant intra-articular injections of autologous tissue-like stromal vascular fraction (tSVF), compared to arthrocentesis alone, in reducing pain and improving mouth opening in TMJ osteoarthritis patients. MATERIALS AND METHODS The primary endpoint analysis will consist of the visual analogue scale (VAS) for pain. The secondary endpoint analyses will include maximal interincisal mouth opening measurements; assessment of oral health and mandibular function based on the oral health impact profile (OHIP) questionnaire and mandibular functional impairment questionnaire (MFIQ); complications during the follow up; synovial cytokine analysis at baseline and after 26 weeks; and nucleated cells and tSVF (immuno)histochemistry analyses of the intervention group. DISCUSSION Our randomized clinical trial protocol will be applied to evaluate the efficacy of a new promising tSVF injection therapy for TMJ osteoarthritis. The safety of intra-articular injections of tSVF has been proven for knee osteoarthritis. However, since a tSVF injection is considered a heterologous application of cell therapy, the regulatory requirements are strict, which makes medical ethical approval challenging.
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Affiliation(s)
- Jan Aart M Schipper
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - Aartje Jorien Tuin
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - Joris A van Dongen
- Department of Plastic Surgery, University Medical Center Utrecht, University of Utrecht, 3584 Utrecht, The Netherlands
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands
| | - Nico B van Bakelen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
| | - Martin Conrad Harmsen
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands
| | - Fred K L Spijkervet
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, 9713 Groningen, The Netherlands
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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: 7] [Impact Index Per Article: 7.0] [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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