Multiple intra-articular injections of autologous stromal vascular fractions for the treatment of multicompartmental osteoarthritis in both the tibiofemoral and patellofemoral joint: a single-blind randomized controlled study.

Background Multicompartmental osteoarthritis (MOA) in both tibiofemoral and patellofemoral joints is a more commonly occurring, but neglected, clinical condition, and we examined the short-term safety and efficacy of autologous stromal vascular fractions (SVFs) for MOA using a single-blind, prospective, randomized, placebo-controlled trial. Methods Seventy MOA patients were recruited and randomly assigned to the SVF group and hyaluronic acid (HA) group (control group). The scores of visual analog scale, the Western Ontario and McMaster University Osteoarthritis Index, and the Samsung Medical Center patellofemoral scoring system were assessed and compared between the two groups 3, 6 and 12 months after treatment. Results The SVF group had significantly better visual analog scale scores than the HA group at 6 and 12 months after treatment and had better Western Ontario and McMaster University Osteoarthritis Index scores than the HA group only at 6 months after treatment. For Samsung Medical Center patellofemoral scoring system of the patellofemoral joint, the SVF group had significantly better scores than the control group at all postoperative time points. The proportion of patients whose visual analog scale and Western Ontario and McMaster University Osteoarthritis Index scores were above the minimal clinically important improvement was higher in the SVF group than in the HA group in the majority of assessments. The improvement of bone marrow by SVF treatment was significantly better than that of the HA group as observed by pre- and postoperative Magnetic resonance imaging (MRI). Conclusions Multiple intra-articular injection of autologous SVF reduces pain and improves function in the short term in patients with early or midstage MOA. However, there was heterogeneity in the improvement of overall knee and isolated patellofemoral joint after treatment.   What is already known on this topic   Knee osteoarthritis (KOA) is the most common type of degenerative joint disease in humans. Autologous stromal vascular fraction (SVF) has been gradually applied to the treatment of KOA due to its multidifferentiation and ease of access. However, most current studies have focused on the tibiofemoral (TF) joint, and we know little about the performance of SVF in multiple compartments of the knee, including the patellofemoral (PF) joint. What this study adds   Multiple intra-articular injections of SVF are safe and effective for MOA in short-term (within 12 months) follow-up. Patients with MOA appear to have different feedback on treatment in different compartments of the knee, including the PF and TF joints, after SVF treatment. How this study might affect research, practice, or policy   More research is needed to clarify the appropriate dosage and injection schedule of SVF to standardize its clinical use. The rational selection of the indications for SVF in the treatment of KOA needs to be done more carefully when OA affects multiple compartments of the knee joint. [ABSTRACT FROM AUTHOR]