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References

To date there are 28 publications with over 1800 patients reported who have received cell therapy to the knee joint, with longest being for 11 years. Those publications which looked at efficacy of treatment all reported improvement in symptoms and/or cartilage regeneration. A full list is attached, the more recent articles tend to now focus on SVF and adipose tissue.

 

A recent paper presented by Dr Michalek at the 2013 International Federation for Adipose Therapeutics and Science meeting in New York revealed successful results of cell therapy for patients suffering from osteoarthritis.

 

Since 2011, a total of 275 patients have been recruited and followed for up to 24 months to demonstrate the therapeutic potential of freshly isolated SVF cells. At the same time, one to four joints (knees and hips) were injected with SVF cells per patient. A total number of 433 joints were treated.

Within 1-2 weeks from SVF therapy 85% of patients were off the non-steroid analgesics and remained off these analgesics for at least 6 months. After 3 months from SVF therapy, at least 50% clinical improvement was recognized in 95%, at least 75% clinical improvement in 68%, and complete remission in 54% of patients, respectively. Within 1-2 weeks from SVF therapy 85% of patients were off the non-steroid analgesics and remain such for at least 6 months. No serious side effects, infection or cancer was associated with SVF cell therapy.

Semiquantitative clinical scale evaluation and non-steroid analgesics dependence was used as measurement of the clinical effect. Prior to testing, all patients were diagnosed with stage II-IV osteoarthritis using X-ray and ultrasound, in some cases MRI was also performed to monitor the changes before and after stem cell therapy.

This work was supported in part by the International Consortium for Cell Therapy and Immunotherapy and Czech Ministry of Education.

Clinical results and second-look arthroscopic findings after treatment with adipose-derived stem cells for knee osteoarthritis

Almost all patients showed significant improvement in all clinical outcomes at the final follow-up examination. All clinical results significantly improved at 2-year follow-up compared to 12-month follow-up (P < 0.05). Among elderly patients aged >65 years, only five patients demonstrated worsening of Kellgren-Lawrence grade. On second-look arthroscopy, 87.5 % of elderly patients (14/16) improved or maintained cartilage status at least 2 years postoperatively. Moreover, none of the patients underwent total knee arthroplasty during this 2-year period.

Knee Osteoarthritis

Meniscus Repair

Osteoarthritis of Hips

Tendons

Cited References

1. Moseley, T.A.., M. Zhu, and M.H. Hedrick. Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg, 2006. 118(3 Suppl): p. 121S-128S.

2. Rodriguez, J..P., et al.,  Autologous stromal vascular fraction on therapy for rheumatoid arthritis rationale and clinical safety. Int Arch Med, 2012. 5: p. 5.

3. NIH webpage: Information on stem cells 

4. Karp, J.M. and G.S. Leng Teo, Mesenchymal stem cell homing: the devi lis in the details. Cell Stem Cell, 2009. 4(3): p. 206-16

5. MacFarlane, R.J., et al., An -inflammatory role and immunomodulation of mesenchymal stem cells in systemic joint diseases: potential for treatment. Expert Opin Ther Targets, 2013. 17(3): p. 243-54.

6. Han, J., et al., Adipose tissue is an extramedullary reservoir for functional hematopoiec stem and progenitor cells. Blood,2010. 115(5): p. 957-64

7. Zuk,  P.A., The   adipose-derived  stem  cell:  looking  back  and  looking  ahead.  Mol  Biol  Cell, 2010.  21(11):  p.  1783-7.

8. Chen, H.T., et al., Proliferation and differentiation potential of human adipose-derived mesenchymal stem cells isolated from elderly patients with osteoporotic fractures. J Cell Mol Med,2012.16(3): p.582-93.

9. Lin RZ. Human endothelial colony-forming cells serve as trophic mediators for mesenchymal stem cell engraftment via paracrine signaling. Proc Natl Acad Sci U S A. 2014 Jun 30 

10. Riordan NH. Non-expanded adipose stromal vascular fraction cell therapy for multiple sclerosis

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