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Int Orthop. 2019 Jan;43(1):15-23. doi: 10.1007/s00264-018-4192-4. Epub 2018 Oct 11.

Concentrated adipose tissue infusion for the treatment of knee osteoarthritis: clinical and histological observations.

Author information

1
Center for Research and Medical Studies, A.O.U. Città della Salute e della Scienza, Turin, Italy. roato78@libero.it.
2
Center for Research and Medical Studies, A.O.U. Città della Salute e della Scienza, Turin, Italy.
3
Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Turin, Italy.
4
Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS A.O.U, San Martino, Genoa, Italy.
5
Department of Surgical Sciences, University of Turin, Turin, Italy.
6
Department of Life Sciences & Systems Biology, University of Turin, Turin, Italy.
7
Pathology Unit, A.O.U. Città della Salute e della Scienza of Turin, Turin, Italy.
8
Industrie Biomediche Insubri SA, Mezzovico-Vira, Switzerland.
9
University of Applied Sciences and Arts of Southern Switzerland - SUPSI, Manno, Switzerland.
10
Skin Bank, Department of General and Specialized Surgery, A.O.U. Città della Salute e della Scienza, Turin, Italy.
11
Department of Imaging and Radio-diagnostic, C.T.O. Hospital-A.O.U. Città della Salute e della Scienza, Turin, Italy.

Abstract

PURPOSE:

Osteoarthritis (OA) is characterized by articular cartilage degeneration and subchondral bone sclerosis. OA can benefit of non-surgical treatments with collagenase-isolated stromal vascular fraction (SVF) or cultured-expanded mesenchymal stem cells (ASCs). To avoid high manipulation of the lipoaspirate needed to obtain ASCs and SVF, we investigated whether articular infusions of autologous concentrated adipose tissue are an effective treatment for knee OA patients.

METHODS:

The knee of 20 OA patients was intra-articularly injected with autologous concentrated adipose tissue, obtained after centrifugation of lipoaspirate. Patients' articular functionality and pain were evaluated by VAS and WOMAC scores at three, six and 18 months from infusion. The osteogenic and chondrogenic ability of ASCs contained in the injected adipose tissue was studied in in vitro primary osteoblast and chondrocyte cell cultures, also plated on 3D-bone scaffold. Knee articular biopsies of patients previously treated with adipose tissue were analyzed. Immunohistochemistry (IHC) and scanning electron microscopy (SEM) were performed to detect cell differentiation and tissue regeneration.

RESULTS:

The treatment resulted safe, and all patients reported an improvement in terms of pain reduction and increase of function. According to the osteogenic or chondrogenic stimulation, ASCs expressed alkaline phosphatase or aggrecan, respectively. The presence of a layer of newly formed tissue was visualized by IHC staining and SEM. The biopsy of previously treated knee joints showed new tissue formation, starting from the bone side of the osteochondral lesion.

CONCLUSIONS:

Overall our data indicate that adipose tissue infusion stimulates tissue regeneration and might be considered a safe treatment for knee OA.

KEYWORDS:

Adipose tissue; Knee osteoarthrytis; Mesenchymal stem cell; Regenerative medicine

PMID:
30311059
DOI:
10.1007/s00264-018-4192-4

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