Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2025; 16(1): 99690
Published online Jan 18, 2025. doi: 10.5312/wjo.v16.i1.99690
Current status of nanofat in the management of knee osteoarthritis: A systematic review
Naveen Jeyaraman, Sandeep Shrivastava, VR Ravi, Arulkumar Nallakumarasamy, Madhan Jeyaraman
Naveen Jeyaraman, Sandeep Shrivastava, Arulkumar Nallakumarasamy, Department of Orthopaedics, Datta Meghe Institute of Higher Education and Research, Wardha 442004, Maharashtra, India
Naveen Jeyaraman, VR Ravi, Arulkumar Nallakumarasamy, Madhan Jeyaraman, Department of Regenerative Medicine, Mother Cell Regenerative Centre, Tiruchirappalli 620017, Tamil Nadu, India
Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Author contributions: Jeyaraman N designed the research; Jeyaraman N and Nallakumarasamy A performed the literature review and wrote the manuscript; Shrivastava S, Ravi VR, and Jeyaraman M finalized the manuscript; Jeyaraman M made the figures; All authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Madhan Jeyaraman, MS, PhD, Assistant Professor, Research Associate, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com
Received: July 28, 2024
Revised: December 7, 2024
Accepted: December 25, 2024
Published online: January 18, 2025
Processing time: 169 Days and 1.5 Hours
Abstract
BACKGROUND

Osteoarthritis (OA) is a prevalent joint disorder requiring innovative treatment approaches.

AIM

To evaluate the use of nanofat, a specialized form of adipose tissue-derived cells, in the treatment of OA, by examining its efficacy, safety profile, mechanisms of action, comparative effectiveness, and long-term outcomes.

METHODS

A comprehensive review of preclinical studies, clinical trials, and in vitro investigations was conducted. The included studies provided insights into the potential role of nanofat in OA treatment, addressing its efficacy, safety profile, mechanisms of action, comparative effectiveness, and long-term outcomes.

RESULTS

Clinical studies consistently reported the efficacy of nanofat in providing pain relief and functional improvement in patients with OA. Local adverse events were limited to the injection site, such as localized pain and inflammation, and resolved within a few days to weeks. Systemic adverse events were rare, and no significant long-term complications were observed. Mechanistically, nanofat was found to enhance chondrocyte proliferation, reduce inflammation, and promote angiogenesis, thereby contributing to its therapeutic effects.

CONCLUSION

Nanofat therapy holds promise as a therapeutic option for managing OA, providing pain relief, functional improvement, and potential tissue regeneration. The safety profile of nanofat treatment appears favorable, but long-term data are still limited. Standardized protocols, larger randomized controlled trials, longer follow-up periods, and cost-effectiveness evaluations are warranted to establish optimal protocols, comparative effectiveness, and long-term outcomes. Despite current limitations, nanofat therapy demonstrates translational potential and should be considered in clinical practice for OA treatment, with careful patient selection and monitoring.

Keywords: Osteoarthritis; Nanofat; Adipose tissue; Cartilage; Knee

Core Tip: The systematic review establishes that nanofat therapy is a promising intervention for osteoarthritis (OA), offering both pain relief and functional improvement, while also maintaining a favorable safety profile. The therapy's underlying mechanisms include the enhancement of chondrocyte proliferation, reduction of inflammation, and promotion of angiogenesis. Despite these promising findings, the study underscores the need for additional research, particularly in the form of large-scale randomized controlled trials, to validate the long-term efficacy and safety of nanofat therapy in the management of OA.