International Orthopaedics

, Volume 43, Issue 1, pp 7–13 | Cite as

Preliminary results of autologous adipose-derived stem cells in early knee osteoarthritis: identification of a subpopulation with greater response

  • Alfredo Schiavone Panni
  • Michele Vasso
  • Adriano Braile
  • Giuseppe ToroEmail author
  • Annalisa De Cicco
  • Davide Viggiano
  • Federica Lepore
Original Paper



The purpose of this study was to report the clinical and functional results of a series of patients with early knee osteoarthritis (KOA) treated with the intra-articular injection of autologous adipose-derived stem cells (aASCs) plus arthroscopic debridement. The hypothesis was that protocol would significantly improve the clinical and functional outcomes in patients with early KOA.


Fifty-two patients with early KOA, who received arthroscopic debridement followed by percutaneous injection of aASCs, were enrolled into the study and retrospectively analyzed with an average follow-up of 15.3 (range, 6 to 24) months. Patients were assessed through the IKS knee and function scores and VAS pain scale.


The mean IKS knee score improved from 37.4 (range, 14 to 79) points pre-operatively to 62.6 (range, 27 to 95) points at the latest follow-up (p < < 0.01). The mean IKS function score improved from 57.2 (range, 25 to 100) points pre-operatively to 83.0 (range, 35 to 100) points at the latest follow-up (p < < 0.01). The mean VAS score decreased from 8.5 (range, 3 to 10) pre-operatively to 5.1 (range, 0 to 8) at the latest follow-up (p < < 0.01). Additionally, patients with a pre-operative VAS score greater than 8 were found to show greater clinical and functional benefits compared with patients with VAS score lower than 8.


The knee injection of aASCs associated to arthroscopic debridement increased significantly the clinical and functional scores in patients with early KOA at a mid-term follow-up, especially those with higher pre-operative VAS scores.


Adipose-derived stem cells Fat transfer Lipogems Arthroscopic debridement Knee osteoarthritis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Hudetz D, Borić I, Rod E, Jeleč Ž, Radić A, Vrdoljak T, Skelin A, Lauc G, Trbojević-Akmačić I, Plečko M, Polašek O, Primorac D (2017) The effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis. Genes (Basel) 13;8(10):270Google Scholar
  2. 2.
    Duymus TM, Mutlu S, Dernek B, Komur B, Aydogmus S, Kesiktas FN (2017) Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc 25:485–492CrossRefGoogle Scholar
  3. 3.
    Khoshbin A, Leroux T, Wasserstein D, Marks P, Theodoropoulos J, Ogilvie-Harris D, Gandhi R, Takhar K, Lum G, Chahal J (2013) The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Arthroscopy 29:2037–2048CrossRefGoogle Scholar
  4. 4.
    Orchard J, Moen MH (2017) Has reimbursement for knee osteoarthritis treatments now reached ‘postfact’ status? Br J Sports Med 51:1510–1511CrossRefGoogle Scholar
  5. 5.
    Caplan AI (2015) Adult mesenchymal stem cells: when, where, and how. Stem Cells Int 2015:628767. CrossRefGoogle Scholar
  6. 6.
    Cuti T, Antunovic M, Marijanovic I, Ivkovic A, Vukasovic A, Matic I, Pecina M, Hudetz D (2017) Capacity of muscle derived stem cells and pericytes to promote tendon graft integration and ligamentization following anterior cruciate ligament reconstruction. Int Orthop 41:1189–1198CrossRefGoogle Scholar
  7. 7.
    Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, Sensebe L, Casteilla L, Fleury S, Bourin P, Noël D, Canovas F, Cyteval C, Lisignoli G, Schrauth J, Haddad D, Domergue S, Noeth U, Jorgensen C, ADIPOA Consortium (2016) Adipose mesenchymal stromal cell-based therapy for severe osteoarthritis of the knee: a phase I dose-escalation trial. Stem Cells Transl Med 5:847–856CrossRefGoogle Scholar
  8. 8.
    Hurley ET, Yasui Y, Gianakos AL, Seow D, Shimozono Y, Kerkhoffs GMMJ, Kennedy JG (2018) Limited evidence for adipose-derived stem cell therapy on the treatment of osteoarthritis. Knee Surg Sports Traumatol Arthrosc.
  9. 9.
    Adriani E, Moio M, Di Paola B, Salustri W, Alfieri A, Parisi P, Ruggiero M, Borab Z, Carlesimo B (2017) Percutaneous fat transfer to treat knee osteoarthritis symptoms: preliminary results. Joints 5:89–92CrossRefGoogle Scholar
  10. 10.
    Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A (2006) Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint. Am J Roentgenol 187:794–799CrossRefGoogle Scholar
  11. 11.
    Misso ML, Pitt VJ, Jones KM, Barnes HN, Piterman L, Green SE (2008) Quality and consistency of clinical practice guidelines for diagnosis and management of osteoarthritis of the hip and knee: a descriptive overview of published guidelines. Med J Aust 189:394–399Google Scholar
  12. 12.
    Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C (2013) A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 22:2063–2077CrossRefGoogle Scholar
  13. 13.
    Schiavone Panni A, Del Regno C, Mazzitelli G, D’Apolito R, Corona K, Vasso M (2017) Good clinical results with autologous matrix-induced chondrogenesis (Amic) technique in large knee chondral defects. Knee Surg Sports Traumatol Arthrosc.
  14. 14.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop Relat Res 248:13–14Google Scholar
  15. 15.
    Cui GH, Wang YY, Li CJ, Shi CH, Wang WS (2016) Efficacy of mesenchymal stem cells in treating patients with osteoarthritis of the knee: a meta-analysis. Exp Ther Med 12:3390–3400CrossRefGoogle Scholar
  16. 16.
    Jo CH, Chai JW, Jeong EC, Oh S, Shin JS, Shim H, Yoon KS (2017) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a 2-year follow-up study. Am J Sports Med 45:2774–2783CrossRefGoogle Scholar
  17. 17.
    Krüger JP, Freymannx U, Vetterlein S, Neumann K, Endres M, Kaps C (2013) Bioactive factors in platelet-rich plasma obtained by apheresis. Transfus Med Hemother 40:432–440CrossRefGoogle Scholar
  18. 18.
    Pak J, Lee JH, Kartolo WA, Lee SH (2016) Cartilage regeneration in human with adipose tissue-derived stem cells: current status in clinical implications. Biomed Res Int 2016:4702674. CrossRefGoogle Scholar
  19. 19.
    Pak J, Lee JH, Park KS, Jeong BC, Lee SH (2016) Regeneration of cartilage in human knee osteoarthritis with autologous adipose tissue-derived stem cells and autologous extracellular matrix. Biores Open Access 5:192–200CrossRefGoogle Scholar
  20. 20.
    Grieshober JA, Stanton M, Gambardella R (2016) Debridement of articular cartilage: the natural course. Sports Med Arthrosc Rev 24:56–62CrossRefGoogle Scholar
  21. 21.
    Katz JN, Brownlee SA, Jones MH (2014) The role of arthroscopy in the management of knee osteoarthritis. Best Pract Res Clin Rheumatol 28:143–156CrossRefGoogle Scholar
  22. 22.
    Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M, Seil R (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 25:335–346CrossRefGoogle Scholar
  23. 23.
    Gu X, Li C, Yin F, Yang G (2017) Adipose-derived stem cells in articular cartilage regeneration: current concepts and optimization strategies. Histol Histopathol.

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Alfredo Schiavone Panni
    • 1
  • Michele Vasso
    • 1
  • Adriano Braile
    • 1
  • Giuseppe Toro
    • 1
    Email author
  • Annalisa De Cicco
    • 1
  • Davide Viggiano
    • 2
  • Federica Lepore
    • 1
  1. 1.Multidisciplinary Department of Medico-Surgical and Dentistry SpecialtiesUniversity of the Campania “Luigi Vanvitelli”NaplesItaly
  2. 2.Department of Medical, Surgical, Neurological, Metabolic and Geriatrics SciencesUniversity of the Campania “Luigi Vanvitelli”NaplesItaly

Personalised recommendations