Adipose-derived stromal vascular fraction (SVF) for the treatment of osteoarthritis of the knee, functional outcome and anatomic recovery of the cartilage: a case report

Background: Osteoarthritis (OA) is a degenerative debilitating disease characterized by progressive erosion of the articular cartilage. Current treatment approaches are reduced to control the associated symptoms, leaving the degenerative changes to progress until a joint replacement becomes mandatory. Therefore, disease-modifying therapeutic alternatives are warranted to improve the patient’s quality of life as well as to ameliorate the high economic impact this disease pose on the healthcare system. Objective: We present a case study of a 42-yearold male with stage 3-4 (clinical) and grade 3 and 4 (radiological) OA, to support the evidence of a positive effect of intra-articularly injected Mesenchymal Stem Cells (MSC)-containing adiposederived stromal vascular fraction (SVF) on both clinical and articular cartilage structural outcomes. Materials and Methods: To obtain the SVF, the patient underwent liposuction and the lipoaspirate was enzymatically processed. The resulting SVF was locally injected into the knee joint. Resultant symptomatology was assessed using the KOOS (Knee Osteoarthritis Objective Score) and the structural response was documented using ultrasonography, both evaluated at various timepoints. Results: We observed the largest clinical improvement (~130% in the KOOS score) in the first 6 weeks, stabilized at 24 weeks, and persisted at 20 month. Notable, ultrasonographic changes included progressive widening of joint spaces, elimination of effusions and thickening of articular cartilage that started as early as 6 weeks and persisted throughout the evaluation period. Conclusions: Cell-based therapy for advanced knee OA using MSC-containing adipose-derived SVF was subjectively and objectively positive for the patient. The KOOS and ultrasonographic measurements were simple and aligned with the patient's course response, providing additional evidence of a positive effect both clinically and structurally. In addition, the results here highlight the importance of consecutive measurements with an inexpensive approach to appreciate the biological process of such therapy for OA and to establish a response curve.