From the Guidelines
Adipose-derived stem cells (ADSCs) for osteoarthritis should ideally be injected during early to moderate stages of the disease (Kellgren-Lawrence grades 1-3) when there is still adequate joint structure remaining and before severe joint degeneration occurs. The optimal timing is after conservative treatments like physical therapy, weight management, and anti-inflammatory medications have been tried without adequate relief, but before the patient requires total joint replacement, as recommended by the American College of Rheumatology and Arthritis Foundation guidelines 1.
Key Considerations
- The procedure typically involves harvesting adipose tissue through mini-liposuction (usually from the abdomen or thigh), processing it to isolate the stem cells, and then injecting them directly into the affected joint under ultrasound or fluoroscopic guidance.
- Patients generally receive a single injection, though some protocols may involve 2-3 injections spaced 1-3 months apart.
- Following injection, patients should limit strenuous activity for 1-2 weeks and gradually return to normal activities.
Therapeutic Effect
The therapeutic effect is based on the cells' ability to reduce inflammation, promote tissue repair, and modulate the immune response within the joint environment, which is crucial for improving morbidity, mortality, and quality of life in patients with osteoarthritis.
Expected Outcomes
While results vary between patients, improvement typically begins within 1-3 months and may last 6-24 months before considering repeat treatment, as supported by the latest guidelines and research in the field 1.
Important Notes
It is essential to prioritize the patient's overall health and well-being when considering ADSCs for osteoarthritis treatment, and to carefully evaluate the potential benefits and risks of this treatment option in the context of current evidence and guidelines.
From the Research
Timing of ADSCs Injection for OA Treatment
The optimal timing for injecting Adipose-Derived Stem Cells (ADSCs) for the treatment of Osteoarthritis (OA) is not explicitly stated in the provided studies. However, the studies suggest that ADSCs can be effective in treating OA, with significant improvements in clinical and radiological outcomes, as well as reduced pain and inflammation.
Key Findings
- A study published in 2020 2 found that intra-articular injections of ADSCs or stromal vascular fraction (SVF) are safe and effective for treating knee OA, with good clinical and radiological outcomes in the early follow-up period (12-24 months).
- Another study published in 2022 3 demonstrated that ADSCs can alleviate OA cartilage lesions in rats and promote the proliferation of chondrocytes, with a paracrine-based mode of action.
- A comparative study published in 2017 4 found that subcutaneous adipose tissue is an effective cell source for cell therapy of OA, promoting stem cell differentiation into chondrocytes and inhibiting immunological reactions.
- A study published in 2022 5 found that the intra-articular injection of ADSCs, with or without platelet-rich plasma (PRP), can decrease pain and reduce inflammation in knee OA, with improved functionality.
- A study published in 2020 6 found that serial PRP injections and a single ADSC+PRP injection can yield improved and sustained functional outcome scores for patients with severe, refractory OA of the knee.
Considerations for ADSCs Injection
- The studies suggest that ADSCs can be effective in treating OA, but the optimal timing and dosage of ADSCs injection are not clearly established.
- The use of ADSCs in combination with other treatments, such as PRP, may enhance the therapeutic effects 5, 6.
- Further studies are needed to determine the long-term efficacy and safety of ADSCs injection for OA treatment, as well as to establish standardized protocols for ADSCs preparation and injection.