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Br Med Bull. 2017 Dec 1;124(1):31-54. doi: 10.1093/bmb/ldx030.

Adipose-derived stem cells in orthopaedic pathologies.

Author information

1
Foot and Ankle Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
2
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy.
3
Department of Orthopaedics and Traumatology, Azienda Ospedaliera San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Italy.
4
Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, UK.

Abstract

Introduction:

To examine the current literature regarding the clinical application of adipose-derived stem cells (ADSCs) for the management of orthopaedic pathologies.

Sources of data:

MEDLINE,SCOPUS, CINAHL and EMBASE (1950 to April 14, 2017) were searched by two independent investigators for articles published in English. Reviews, meta-analyses, expert opinions, case reports, mini case series and editorials were excluded. Furthermore, we excluded animal studies, cadaveric studies and in vitro studies.

Areas of agreement:

ADSCs seem to produce excellent clinical results. However, the length and modalities of follow-up in the different conditions are extremely variable. Nevertheless, it appears that the use of adipose-derived stem cells is associated with subjective and objective clinical improvements and minimal complication rates.

Areas of controversy:

None of the studies identified is a randomized double-blinded trial, and most of the selected studies present major limitations, and different methods, confounding the results of our review.

Growing points:

It is necessary to conduct more and better studies to ascertain whether ADSCs really play a role in orthopaedic surgery with particular attention to ADSCs harvesting method, type of administration and the conditions treated.

Areas timely for developing research:

The current literature regarding the use of ADSCs for orthopaedic pathologies is limited. At present, long-term safety is the biggest challenge of ADSCs based regenerative medicine.

Level of evidence:

Level IV-Study of Level I, II, III, IV.

KEYWORDS:

PRP; adipose-derived stem cells; injection; mesenchymal stem cells; regenerative medicine; scaffold; stromal vascular fraction

PMID:
29253149
DOI:
10.1093/bmb/ldx030
[Indexed for MEDLINE]

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