Background Adipose-derived stromal vascular fraction (SVF) cells are a mixed cell population that includes cells with multilineage potential, similar to bone marrow-derived mesenchymal stem cells. Our purpose is to investigate the influence of SVF cells in patients with knee osteoarthritis (OA) and the short-term treatment effects.
Methods Fifty-seven patients were enrolled and treated with intra-articular injection of 5.0×10 7 SVF cells into the knee joint between September 2017 and March 2018. All patients were followed up for 12 months or longer. Mean age at treatment and follow-up period were 69.4±6.9 years and 13.7±2.0 months, respectively. The mean preoperative HKA angle was 6.7±3.6°. SVF cells were prepared using the Celution®800/CRS system from the patients’ abdominal or breech subcutaneous fat. The mean SVF cell viability was 90.6±2.7%. Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the HKA angle assessed via radiography, and T2 mapping value using a 3.0-T magnetic resonance imaging unit were also assessed. Both clinical and imaging evaluations were performed preoperatively, 1, 3, 6, and 12 months postoperatively, and compared among all timepoints (p<0.05).
Results Knee extension angle at 6 and 12 months postoperatively was significantly better than the preoperative angle. Total WOMAC, VAS, and KOOS scores at 1, 3, 6 and 12 months postoperatively were significantly better than preoperative scores. There was no significant difference in HKA angle among the five time periods. T2 mapping values of lateral femur and tibia were significantly higher 12 months postoperatively than preoperatively.
Conclusions The short-term clinical effects of intra-articular SVF cell injection on knee OA were excellent. Intra-articular SVF cell injection is a novel and innovative approach for treating patients with knee OA.

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On 02 Mar, 2020
On 01 Mar, 2020
On 01 Mar, 2020
Posted 21 Jan, 2020
Received 22 Feb, 2020
Received 22 Feb, 2020
On 22 Feb, 2020
On 13 Feb, 2020
On 12 Feb, 2020
Invitations sent on 02 Feb, 2020
On 02 Feb, 2020
On 21 Jan, 2020
On 17 Jan, 2020
On 16 Jan, 2020
On 10 Jan, 2020
On 02 Mar, 2020
On 01 Mar, 2020
On 01 Mar, 2020
Posted 21 Jan, 2020
Received 22 Feb, 2020
Received 22 Feb, 2020
On 22 Feb, 2020
On 13 Feb, 2020
On 12 Feb, 2020
Invitations sent on 02 Feb, 2020
On 02 Feb, 2020
On 21 Jan, 2020
On 17 Jan, 2020
On 16 Jan, 2020
On 10 Jan, 2020
Background Adipose-derived stromal vascular fraction (SVF) cells are a mixed cell population that includes cells with multilineage potential, similar to bone marrow-derived mesenchymal stem cells. Our purpose is to investigate the influence of SVF cells in patients with knee osteoarthritis (OA) and the short-term treatment effects.
Methods Fifty-seven patients were enrolled and treated with intra-articular injection of 5.0×10 7 SVF cells into the knee joint between September 2017 and March 2018. All patients were followed up for 12 months or longer. Mean age at treatment and follow-up period were 69.4±6.9 years and 13.7±2.0 months, respectively. The mean preoperative HKA angle was 6.7±3.6°. SVF cells were prepared using the Celution®800/CRS system from the patients’ abdominal or breech subcutaneous fat. The mean SVF cell viability was 90.6±2.7%. Clinical evaluations were performed for range of motion, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, which included the HKA angle assessed via radiography, and T2 mapping value using a 3.0-T magnetic resonance imaging unit were also assessed. Both clinical and imaging evaluations were performed preoperatively, 1, 3, 6, and 12 months postoperatively, and compared among all timepoints (p<0.05).
Results Knee extension angle at 6 and 12 months postoperatively was significantly better than the preoperative angle. Total WOMAC, VAS, and KOOS scores at 1, 3, 6 and 12 months postoperatively were significantly better than preoperative scores. There was no significant difference in HKA angle among the five time periods. T2 mapping values of lateral femur and tibia were significantly higher 12 months postoperatively than preoperatively.
Conclusions The short-term clinical effects of intra-articular SVF cell injection on knee OA were excellent. Intra-articular SVF cell injection is a novel and innovative approach for treating patients with knee OA.

Figure 1

Figure 2

Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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