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. 2024 Apr 25;13(9):750.
doi: 10.3390/cells13090750.

Intra-Articular Application of Autologous, Fat-Derived Orthobiologics in the Treatment of Knee Osteoarthritis: A Systematic Review

Matthias Holzbauer  1   2 , Eleni Priglinger  1   2 , Stig-Frederik Trojahn Kølle  3 , Lukas Prantl  4 , Christian Stadler  1   2 , Philipp Wilhelm Winkler  1   2 , Tobias Gotterbarm  1   2 , Dominik Duscher  4   5
Affiliations

Intra-Articular Application of Autologous, Fat-Derived Orthobiologics in the Treatment of Knee Osteoarthritis: A Systematic Review

Matthias Holzbauer et al. Cells. .

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.

Keywords: adipose tissue-derived stromal cells; cartilage regeneration; knee osteoarthritis; mesenchymal stem cells; orthobiologics; stromal vascular fraction.

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Conflict of interest statement

The authors declare no conflicts of interest. Liparthroplasty and Supercharged Liparthroplasty are Trademarks owned by Dominik Duscher.

Figures

Figure 1
Figure 1
PRISMA flowchart indicating the review process.
Figure 2
Figure 2
Patients categorized by (a) fat-derived orthobiologic type and (b) continent. Legends: ASC (adipose tissue-derived stromal/stem cells); cSVF (cellular stromal vascular fraction); tSVF (tissue stromal vascular fraction).
Figure 3
Figure 3
Number of patients included in this review with their follow-up period.
See this image and copyright information in PMC

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