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Systematic Review

A Worldwide Analysis of Adipose-Derived Stem Cells and Stromal Vascular Fraction in Orthopedics: Current Evidence and Applications

by
Robert Ossendorff
1,*,†,
Alessandra Menon
2,3,4,†,
Frank A. Schildberg
1,
Pietro S. Randelli
2,3,5,
Sebastian Scheidt
1,
Christof Burger
1,
Dieter C. Wirtz
1 and
Davide Cucchi
1
1
Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
2
Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
3
U.O.C. 1° Clinica Ortopedica, ASST Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
4
Dipartimento di Scienze Cliniche e di Comunità, Scuola di Specializzazione in Statistica Sanitaria e Biometria, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
5
Research Center for Adult and Pediatric Rheumatic Diseases (RECAP-RD), Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2023, 12(14), 4719; https://doi.org/10.3390/jcm12144719
Submission received: 2 May 2023 / Revised: 15 June 2023 / Accepted: 11 July 2023 / Published: 17 July 2023
(This article belongs to the Special Issue Osteoarthritis: Diagnosis and Therapeutic Approaches)
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Abstract

The biological enhancement of tissue regeneration and healing is an appealing perspective in orthopedics. We aimed to conduct a systematic review to describe the global distribution of studies investigating the use of adipose tissue derivates in orthopedics and to provide information on their quality and on the products available. The quality of the included studies was assessed using the modified Coleman Methodology Score (mCMS) and the Cochrane risk-of-bias tool for randomized trials. Eighty-two studies were included, with a total of 3594 patients treated. In total, 70% of the studies investigated the treatment of knee disorders, predominantly osteoarthritis; 26% of all studies dealt with expanded adipose-derived stem/stromal cells (ADSCs), 72% of which had stromal vascular fraction (SVF); 70% described the injection of adipose tissue derivates into the affected site; and 24% described arthroscopies with the addition of adipose tissue derivates. The mean mCMS for all studies was 51.7 ± 21.4 points, with a significantly higher score for the studies dealing with expanded ADSCs compared to those dealing with SVF (p = 0.0027). Our analysis shows high heterogeneity in terms of the types of performed procedures as well as the choice and processing of adipose tissue derivates.
Keywords: osteoarthritis; adipose tissue; mesenchymal stem; stromal cells; adipose-derived stem; stromal vascular fraction; microfragmented adipose tissue; regenerative medicine osteoarthritis; adipose tissue; mesenchymal stem; stromal cells; adipose-derived stem; stromal vascular fraction; microfragmented adipose tissue; regenerative medicine

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MDPI and ACS Style

Ossendorff, R.; Menon, A.; Schildberg, F.A.; Randelli, P.S.; Scheidt, S.; Burger, C.; Wirtz, D.C.; Cucchi, D. A Worldwide Analysis of Adipose-Derived Stem Cells and Stromal Vascular Fraction in Orthopedics: Current Evidence and Applications. J. Clin. Med. 2023, 12, 4719. https://doi.org/10.3390/jcm12144719

AMA Style

Ossendorff R, Menon A, Schildberg FA, Randelli PS, Scheidt S, Burger C, Wirtz DC, Cucchi D. A Worldwide Analysis of Adipose-Derived Stem Cells and Stromal Vascular Fraction in Orthopedics: Current Evidence and Applications. Journal of Clinical Medicine. 2023; 12(14):4719. https://doi.org/10.3390/jcm12144719

Chicago/Turabian Style

Ossendorff, Robert, Alessandra Menon, Frank A. Schildberg, Pietro S. Randelli, Sebastian Scheidt, Christof Burger, Dieter C. Wirtz, and Davide Cucchi. 2023. "A Worldwide Analysis of Adipose-Derived Stem Cells and Stromal Vascular Fraction in Orthopedics: Current Evidence and Applications" Journal of Clinical Medicine 12, no. 14: 4719. https://doi.org/10.3390/jcm12144719

APA Style

Ossendorff, R., Menon, A., Schildberg, F. A., Randelli, P. S., Scheidt, S., Burger, C., Wirtz, D. C., & Cucchi, D. (2023). A Worldwide Analysis of Adipose-Derived Stem Cells and Stromal Vascular Fraction in Orthopedics: Current Evidence and Applications. Journal of Clinical Medicine, 12(14), 4719. https://doi.org/10.3390/jcm12144719

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