Use of Autologous Adipose-derived Stromal Vascular Fraction Grafting in Treatment of Knee Osteoarthritis: A Safety and Efficacy Study
Journal Title: Journal of Medical Research and Practice - Year 2017, Vol 6, Issue 4
Abstract
Autologous adipose-derived stromal vascular fraction (SVF) grafting done in a single surgical sitting was used to treat 201 osteoarthritic knees of grades II or III (as per Kellgren and Lawrence classification scale) under an IEC-approved protocol for its safety and efficacy study in Indians. The primary objective of this study was to determine if adipose-derived SVF can be safely used for intra-articular injection of the knee. The secondary objective of this study was to evaluate the efficacy of an intra-articular grafting of adipose-derived SVF for pain relief in osteoarthritic knees. SVF was obtained through lipoaspirated adipose tissue without using enzymes or chemicals or animal products which is grafted into the intra-articular space of effected joint. Patient pain data were obtained at per SVF grafting as well as post grafting at 3-, 6-, 9-,12- and 24-month follow up using Knee injury and Osteoarthritis Outcome Score (KOOS) to access statistical significance for the 5 subscales; pain, other symptoms, function in daily living (ADL), function in sport and recreation (Sport/Rec) and knee-related quality of life (QOL) to access improvisation. Adipose-derived SVF of adipose tissue is a rich source of preadipocytes, Pericytes, endothelial progenitor cell, T cells, B cells, mast cells as well as adipose tissue macrophages obtained from loose connective tissue can significantly improve outcome of degenerative OA leading to a better QOL. A total of 201 joints mainly knee OA were treated with autologous grafting of SVF done in a single surgical sitting. A total of 201 joints studied out of which 60 joints were followed up for 24 months, 107 joints followed for 12 months, 127 joints are followed for 9 months, 160 joints followed for 6 months and finally all 201 joints were followed for minimum 3 months for safety and efficacy. Modified KOOS Clinical Score was used to evaluate clinical effect and was based on pain, non-steroid analgesic usage, limping, extent of joint movement, and stiffness evaluation before and at pre-operative, 1, 6, 9, 12 and 24 months post-op after grafting. No side effects,systemic infection or cancer were associated with autologous grafting of SVF. There was a significant improvement from pre-op to post-op in all the followed patients. Average KOOS score improved from pre-operative 45.09 to post-operative 24 months average 80.27, which is a very significant improvement in all grades. All sub-scale parameters for pain, symptoms, activity of living and QOL showed significant improvement. Higher grade of OA was associated with comparatively slower healing. Autologous grafting of SVF in single surgical sitting is a novel and promising treatment approach for patients with degenerative OA. This treatment method was found to be minimal invasive, safe and cost-effective treatment modality for osteoarthritis
Authors and Affiliations
Vinay Tantuway, Ashish K. Sharma, Manoj H. Mehta, Pankaj Mehto, Murtuza Rassiwala
Keywords
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