Therapeutic applications of adipose-derived stromal vascular fractions in osteoarthritis

Table 2 Clinical researches on the treatment of osteoarthritis with stromal vascular fraction

Ref.	Treatment	Study type	Patients	Follow-up time	Outcome assessments	Consequences
		OA position/number
Pak et al[41,42] (2016, 2018)	SVF + HA + PRP	Case report	3 patients: 1 male, age: 68; 2 females, age: 60 and 87	3.5 mo	FRI, MRI, ROM, VAS	Cartilage repaired showed by MRI; all scores improved
		Knee
Fodor et al[43] (2016)	SVF	Pilot study	6 patients: 1 male, 5 females, mean age: 59	12 mo	ROM, WOMAC, VAS, TUG, MRI	All scores improved, no MRI evidence of cartilage regeneration
NCT02357485		Knee/8 OA
Yokota et al[44] (2017)	SVF	Case report	13 patients: 2 males, 11 females, mean age: 74.5	6 mo	VAS, JKOM, WOMAC	All scores improved
		Knee/26 OA
Nguyen et al[45] (2017)	AM vs AM + SVF + PRP	Comparative study	30 patients (15 per group: 3 males, 12 females) mean age: 58	18 mo	VAS, Lysholm, WOMAC, MRI	All scores improved compared with AM group; AM + SVF + PRP group had obvious cartilage repair show by MRI
NCT02142842		Knee
Michalek et al[46] (2017)	SVF	Case control multi-centric non-randomized study	1128 patients: 596 males, 532 females, median age: 62	17.2 mo	Modified KOOS/HOOS	KOOS/HOOS improved, most patients gradually improved, obesity and more severe OA healed slowly
		Knee and hip/1856 OA
Tantuway et al[47] (2017)	SVF	Case report	101 patients: 41 males, 60 females, age: 29-84	3-24 mo	KOOS	KOOS and joint function improved, pain relieved, patients could move normally
		Knee/201 OA
Russo et al[48,49] (2017, 2018)	SVF	Retrospective study	30 patients: 21 males, 9 females, median age: 43	12-36 mo	Lysholm, VAS, IKDC-subjective, KOOS	41%, 55%, 55%, 64% of the patients improved in the scores, respectively
		Diffuse degenerative keen
Bright et al[50] (2018)	SVF	Case report	1 patient: female, age: 27	3 yr	WOMAC, HOOS	Symptoms of OA reduced, all scores improved, ankylosing spondylitis, depression, anxiety and fatigue improved
		Knee and hip
Barfod et al[51] (2019)	SVF	Prospective cohort study	20 patients, mean age: 49	12 mo	KOOS	KOOS improved
NCT02697682		Knee
Roato et al[52] (2019)	SVF	Case report	20 patients: 9 males, 11 females, mean age: 59.6	18 mo	VAS, WOMAC	Pain relieved, scores improved
		Knee
Hudetz et al[53] (2019)	SVF	Prospective, non-randomized and single center study	20 patients: 15 males, 5 females	12 mo	VAS, WOMAC, KOOS	All scores improved, pain and symptoms relieved for up to a year
		Knee
Berman et al[54] (2019)	SVF	Case report	2586 patients	2-5 yr	Questionnaire (visual acuity pain scores, sustained improvement in function)	Over 80% of patients' pain relieved, joint function improved and maintain 1 yr; outcomes between male and female or between SVF alone and SVF + PRP showed no difference
NCT10953523		Knee
Michalek et al[55] (2019)	SVF	Multicenter case-control study	29 patients: 9 males, 20 females, mean age: 83.3	36 mo	Modified KOOS/HOOS	Apart from 3 elderly patients died from aging, other patients' pain and weekly dosage of analgesics were reduced, KOOS/HOOS improved
		Knee and hip
Yokota et al[56] (2019)	ADSC vs SVF	Retrospective cohort study	ADSC: 42 patients; SVF: 38 patients	6 mo	VAS, KOOS	No major complications occurred, knee joint effusion was more likely to occur in SVF group than ADSC group (SVF 8%, ADSC 2%); VAS and KOOS improved in both groups
		Knee/128 OA
Mayoly et al[57] (2019)	SVF +PRP	Case report	3 patients: 1 male, 2 females, mean age: 62	12 mo	VAS, PRWE, DASH	All scores improved
NCT03164122		Wrist
Hong et al[58] (2019)	SVF vs HA	Double-blind randomized self-controlled trial	16 patients (with bilateral symptomatic knee OA) one side: SVF, the other side: HA. 3 males, 13 females, mean age: 52	12 mo	VAS, WOMAC, ROM, MRI (MOCART, WORMS)	Significant improvement of VAS, WOMAC and ROM in SVF group, but no improvement in HA group; SVF group was superior to HA group in cartilage repair showed by MOCART and WORMS
		Knee
Tran et al[59] (2019)	SVF + AM vs AM	Single-center, non-randomized, placebo-controlled study	33 patients, placebo group (AM): 3 males, 12 females, mean age: 58.2; SVF group (SVF + AM): 5 males, 13 females, mean age: 59	24 mo	VAS, WOMAC, Lysholm, OS	VAS, WOMAC of SVF group reduced significantly compared with placebo group, and maintained 24 mo; Lysholm, OS of SVF group improved
		Knee
Garza et al[60] (2020)	SVF	Double-blinded prospective randomized controlled study	39 patients (randomly assigned to high-, low-dose SVF, or placebo at 1:1:1)	12 mo	WOMAC, MRI	Symptoms and pain relieved by SVF treatment for up to at least 12 mo; changes in WOMAC scores reached statistical significance in the high- and low-dose groups compared to the placebo group; the improvements were dose dependent
NCT02726945		Knee
Lapuente et al[61] (2020)	SVF	Retrospective study	50 patients: 28 males, 22 females, age: 50-89	12 mo	Lequesne, WOMAC, VAS	All scores improved
		Knee/100 OA
Tsubosaka et al[62] (2020)	SVF	Case report	57 patients: 41 males, 16 females, mean age: 69.4	13.7 mo	ROM, WOMAC, VAS, KOOS, MRI	WOMAC, VAS and KOOS improved, while no significant difference in hip-knee-ankle angle, T2 mapping values of lateral femur and tibia improved significantly
		Knee

HA: Hyaluronic acid; FRI: Functional rating index; MRI: Magnetic resonance imaging; VAS: Visual analogue score; ROM: Range of motion; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; TUG: Timed up-and-go; JKOM: Japanese knee osteoarthritis measure; AM: Arthroscopic microfracture; OS: Outerbridge classification system; KOOS/HOOS: Knee/hip osteoarthritis outcome score; IKDC: International knee documentation committee-subjective; PRWE: Patient-rated wrist evaluation scores; DASH: Disabilities of the arm and shoulder; MOCART: Magnetic resonance observation of cartilage repair tissue score; BME: Bone marrow edema lesions; WORMS: Whole-organ magnetic resonance imaging score.