scholarly journals Platelet Rich STROMA, the Combination of PRP and tSVF and Its Potential Effect on Osteoarthritis of the Knee

2020 ◽  
Vol 10 (14) ◽  
pp. 4691
Author(s):  
Hieronymus P. Stevens ◽  
Joeri van Boxtel ◽  
Robbert van Dijck ◽  
Joris A. van Dongen
Keyword(s):  
Single Injection ◽  
Platelet Rich Plasma ◽  
Joint Stiffness ◽  
Stromal Vascular Fraction ◽  
Case Series ◽  
Visual Analogue Score ◽  
Fixed Time ◽  
Long Term Results ◽  
Osteoarthritis Of The Knee ◽  
Subsequent Decrease

(1) Background: osteoarthritis (OA) of the knee is a degenerative disease accompanied by pain, reduced mobility and subsequent decrease in quality of life. Many studies on OA of the knee have reported that using an intercellular acting-derivate like platelet-rich plasma (PRP) results in a limited effect or none at all. Authors hypothesized that adding tissue-Stromal Vascular Fraction (tSVF) to PRP (Platelet Rich Stroma (PRS)) would reduce pain and improve functionality in osteoarthritis of the knee. (2) Methods: a consecutive case series of fifteen patients (aged 43–75 years) suffering from OA of the knee (Kellgren–Lawrence stage two to three) were treated with a single injection of autologous PRS. tSVF was mechanically isolated by means of the fractionation of adipose tissue (FAT) procedure. Clinical evaluation was done using a visual analogue score (VAS) score, an adapted Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and Lysholm score at fixed time points: pre-injection as well as three, six and twelve months post injection. (3) Results: VAS and WOMAC scores improved significantly after twelve months (p < 0.01 and p < 0.05). Lysholm instability scores were also improved at twelve months (p > 0.05) in comparison to pre-injection measurements. No complications were seen in any of the patients. One patient was excluded due to a total knee arthroplasty. (4) Conclusions: a single injection with PRS for OA of the knee seems to lead to an improvement of function and simultaneous reduction of pain and joint stiffness for a period of twelve months. Further controlled trials are required to determine the optimal treatment regimen and evaluate long-term results.

scholarly journals Treatment of Grade 3 and 4 Osteoarthritis with Intraoperatively Separated Adipose Tissue-Derived Stromal Vascular Fraction: A Comparative Case Series

Cells ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 2096
Author(s):  
Denis Simunec ◽  
Honey Salari ◽  
Juliane Meyer
Keyword(s):  
Adipose Tissue ◽  
Platelet Rich Plasma ◽  
Subjective Evaluation ◽  
Stromal Vascular Fraction ◽  
Case Series ◽  
Joint Space ◽  
Substantial Improvement ◽  
Serious Adverse Events ◽  
Artificial Joint Replacement ◽  
Grade 3

Osteoarthritis (OA) is the most common form of arthritis of the joints. The stromal vascular fraction (SVF) is a regenerative cell population that can be isolated from adipose tissue. It is the immunomodulatory properties of the stromal vascular fraction that make it a promising candidate for the regenerative treatment of OA. Patients with grade 3 and 4 osteoarthritis were treated with the stromal vascular fraction with and without platelet-rich plasma (PRP) and followed up on their Knee Injury and Osteoarthritis Outcome Score (KOOS) score for 12 months, with MRI and subjective evaluation of the procedure. Magnetic resonance imaging (MRI) revealed a widening of the joint space, a restructuring of the cartilage, and an alleviation of effusions in the treated joints. In three of the four treatment groups, a substantial improvement of the KOOS scores was documented at the 12-month follow-up time point. According to the subjective evaluation, 67% of the patients were satisfied or very satisfied with the procedure and would recommend it to others. No serious adverse events or unwanted side effects related to the SVF treatment were observed or reported. Prior to an invasive artificial joint replacement, the treatment of arthritic knee joints with the intraarticular injection of autologous adipose tissue-derived SVF should be considered a regenerative treatment option.

scholarly journals Autologous stromal vascular fraction cells combined with platelet-rich plasma for androgenic alopecia treatment: a case series

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 408
Author(s):  
Fonny Josh ◽  
Tomie Hermawan Soekamto ◽  
Muhammad Faruk
Keyword(s):  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Stromal Vascular Fraction ◽  
Case Series ◽  
Androgenic Alopecia ◽  
Case Presentation ◽  
Therapeutic Outcomes ◽  
Multipotent Cells ◽  
Combined Use

Background: Stromal vascular fraction cells (SVFs), which can be produced using a mechanical or digestive enzymatic process, are heterogeneous cells with the potential to grow hair in androgenic alopecia patients. Platelet-rich plasma (PRP) is an autologous cell source that is widely used to treat androgenic alopecia. However, the combined use of PRP and SVFs to treat alopecia is rarely reported. Case presentation: This case series describes three cases of androgenic alopecia, including a32-year-old male, a 43-year-old male, and a 65-year-old male. Androgenic alopecia in these patients was treated by injecting the bald area of the scalp with local autologous PRP combined with SVFs. Follow-up was performed 1–3 months after treatment, which showed good results. The hair grew denser, with increased thickness for each strand. The hair pull test revealed that the hair remained intact. Conclusion: The combination of PRP and SVFs affected all cycles of the hair growth process. SVFs are multipotent cells with the potential to become antioxidant, anti-inflammatory, or anti-fibrotic cells. SVFs can regenerate cells that secrete the growth factors, that are essential for angiogenesis, which can improve therapeutic outcomes. This case series will enrich the existing literature by expanding available treatment options for androgenic alopecia.

scholarly journals Single Platelet-Rich Plasma Injection for Early Stage of Osteoarthritis of the Knee

Joints ◽  
2017 ◽  
Vol 05 (01) ◽  
pp. 002-006 ◽  
Author(s):  
Liborio Martini ◽  
Alessio Via ◽  
Chiara Fossati ◽  
Filippo Randelli ◽  
Pietro Randelli ◽  
...  
Keyword(s):  
Early Stage ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Womac Score ◽  
Rank Test ◽  
Osteoarthritis Of The Knee ◽  
Low Grade ◽  
Level Of Evidence ◽  
Knee Oa

Purpose The purpose of this study was to determine the safety efficacy and outcomes of platelet-rich plasma (PRP) intra-articular injections for early stages of knee osteoarthritis (OA). Methods Twenty-five patients affected by grade I and II knee primary OA according to the Kellgren–Lawrence scale received a single intra-articular PRP injection. Patients were prospectively evaluated for 6 months. Visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee injury and Osteoarthritis Outcome Score (KOOS) scoring scales were used to evaluate clinical outcomes. Wilcoxon signed rank test was used to evaluate significance of improvement of WOMAC, KOOS, and VAS scores. Results Twenty-one patients completed 6-months follow-up. The median WOMAC score improved from 29.1 points (range: 17.4–60.4; standard deviation [SD] = 13.0) at baseline to 42.41 (range: 24.3–71.2; SD = 12.5) at final follow-up. Improvements in median KOOS and VAS score have been also found, from 37.49 points and 64.2 mm before injection to 59.71 points and 42.8 mm, respectively. All these improvements were statistically significant (p < 0.05). No adverse reactions have been observed. Conclusion Treating knee OA with PRP injection is safe. A single dose of PRP seems to be effective in managing pain and improving quality of life in patients with low-grade knee OA. Level of Evidence Level IV, therapeutic case series.

scholarly journals Minimum 10-Year Clinical Outcome of Lateral Collagen Meniscal Implants for the Replacement of Partial Lateral Meniscal Defects: Further Results From a Prospective Multicenter Study

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712199491
Author(s):  
Alberto Grassi ◽  
Gian Andrea Lucidi ◽  
Giuseppe Filardo ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
Survival Rate ◽  
Case Series ◽  
Final Analysis ◽  
Activity Level ◽  
Long Term Results ◽  
Level Of Evidence ◽  
Unicompartmental Knee Arthroplasties ◽  
Tegner Score

Background: The collagen meniscal implant (CMI) is a biologic scaffold aimed at replacing partial meniscal defects. The long-term results of lateral meniscal replacement have never been investigated. Purpose: To document the clinical outcomes and failures of lateral CMI implantation for partial lateral meniscal defect at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4, Methods: This study included 24 consecutive patients who underwent lateral CMI implantation for partial lateral meniscal defects between April 2006 and September 2009 and who were part of a previous study with a 2-year follow-up. Outcome measures at the latest follow-up included the Lysholm score, Knee injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, Tegner activity level, and EuroQol 5-Dimensions score. Data regarding complications and failures were collected, and patients were asked about their satisfaction with the procedure. Results: Included in the final analysis were 19 patients (16 male, 3 female) with a mean age at surgery of 37.1 ± 12.6 years and a mean follow-up of 12.4 ± 1.5 years (range, 10-14 years). Five failures (26%) were reported: 1 CMI removal because of implant breakage and 4 joint replacements (2 unicompartmental knee arthroplasties and 2 total knee arthroplasties). The implant survival rate was 96% at 2 years, 85% at 5 years, 85% at 10 years, 77% at 12 years, and 64% at 14 years. Lysholm scores at the final follow-up were rated as “excellent” in 36% (5 of 14 nonfailures), “good” in 43% (6 of 14), and “fair” in 21% (3 of 14). The VAS score was 3.1 ± 3.1, with only 16% (3 of 19 patients) reporting that they were pain-free; the median Tegner score was 3 (interquartile range, 2-5). All clinical scores decreased from the 2-year follow-up; however, with the exception of the Tegner score, they remained significantly higher compared with the preoperative status. Overall, 79% of patients were willing to undergo the same procedure. Conclusion: Lateral CMI implantation for partial lateral meniscal defects provided good long-term results, with a 10-year survival rate of 85% and a 14-year survival rate of 64%. At the final follow-up, 58% of the patients had “good” or “excellent” Lysholm scores. However, there was a general decrease in outcome scores between the short- and the long-term follow-up.

Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review

2021 ◽  
pp. 036354652199801
Author(s):  
Michael R. Baria ◽  
W. Kelton Vasileff ◽  
James Borchers ◽  
Alex DiBartola ◽  
David C. Flanigan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Combination Therapy ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Final Analysis ◽  
Preparation Technique ◽  
Randomized Studies ◽  
Patient Reported

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect. Purpose: To systematically review the clinical literature examining the combined use of PRP + HA. Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs). Results: A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone. Conclusion: Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.

scholarly journals Stromal Vascular Fraction for Osteoarthritis of the Knee Regenerative Engineering

2021 ◽  
Author(s):  
Chinedu C. Ude ◽  
Shiv Shah ◽  
Kenneth S. Ogueri ◽  
Lakshmi S. Nair ◽  
Cato T. Laurencin
Keyword(s):  
Quality Of Life ◽  
Clinical Evidence ◽  
Point Of Care ◽  
Stromal Vascular Fraction ◽  
Clinic Visit ◽  
Osteoarthritis Of The Knee ◽  
Clinical Patient ◽  
Inflammatory Proteins ◽  
Anti Inflammatory

Abstract Purpose The knee joint is prone to osteoarthritis (OA) due to its anatomical position, and several reports have implicated the imbalance between catabolic and anabolic processes within the joint as the main culprit, thus leading to investigations towards attenuation of these inflammatory signals for OA treatment. In this review, we have explored clinical evidence supporting the use of stromal vascular fraction (SVF), known for its anti-inflammatory characteristics for the treatment of OA. Methods Searches were made on PubMed, PMC, and Google Scholar with the keywords “adipose fraction knee regeneration, and stromal vascular fraction knee regeneration, and limiting searches within 2017–2020. Results Frequently found interventions include cultured adipose-derived stem cells (ADSCs), SVF, and the micronized/microfragmented adipose tissue-stromal vascular fraction (MAT-SVF). Clinical data reported that joints treated with SVF provided a better quality of life to patients. Currently, MAT-SVF obtained and administered at the point of care is approved by the Food and Drug Administration (FDA), but more studies including manufacturing validation, safety, and proof of pharmacological activity are needed for SVF. The mechanism of action of MAT-SVF is also not fully understood. However, the current hypothesis indicates a direct adherence and integration with the degenerative host tissue, and/or trophic effects resulting from the secretome of constituent cells. Conclusion Our review of the literature on stromal vascular fraction and related therapy use has found evidence of efficacy in results. More research and clinical patient follow-up are needed to determine the proper place of these therapies in the treatment of osteoarthritis of the knee. Lay Summary Reports have implicated the increased inflammatory proteins within the joints as the main cause of osteoarthritis (OA). This has attracted interest towards addressing these inflammatory proteins as a way of treatment for OA. The concentrated cell-packed portion of the adipose product stromal vascular fraction (SVF) from liposuction or other methods possesses anti-inflammatory effects and has been acclaimed to heal OA. Thus, we searched for clinical evidence supporting their use, for OA treatment through examining the literature. Data from various hospitals support that joints treated with SVF provided a better quality of life to patients. Currently, there is at least one version of these products that are obtained and given back to patients during a single clinic visit, approved by the FDA.

Foot and Ankle Injections in Athletes

2021 ◽  
pp. 194173812110036
Author(s):  
Jonathan K. Ochoa ◽  
Christopher E. Gross ◽  
Robert B. Anderson ◽  
Andrew R. Hsu
Keyword(s):  
English Language ◽  
Platelet Rich Plasma ◽  
Empirical Studies ◽  
Autologous Blood ◽  
Case Series ◽  
Placental Tissue ◽  
Ankle Injuries ◽  
Extensive Literature ◽  
Foot And Ankle ◽  
Level Of Evidence

Context: Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety. Evidence Acquisition: An extensive literature review was performed through MEDLINE, Google Scholar, and EBSCOhost from database inception to 2021. Keywords searched were injections, athletes, sports, foot and ankle, corticosteroids, platelet-rich plasma, and placental tissue. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. Study Design: Clinical review. Level of Evidence: Level 4. Results: Corticosteroids, platelet-rich plasma/autologous blood, anesthetic, and placental tissue injections are commonly used in the treatment of foot and ankle injuries. Primary indications for injections in athletes include plantar fasciitis, Achilles tendinosis, isolated syndesmotic injury, and ankle impingement with varying clinical results. Conclusions: Despite promising results from limited case series and comparative studies, the data for safety and efficacy of injections for foot and ankle injuries in athletes remain inconclusive.

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