What Research Tells Us About Stem Cell Treatments for Knee Osteoarthritis
B. Di Matteo, F. Vandenbulcke, N. D. Vitale, F. Iacono, K. Ashmore, M. Marcacci, E. Kon · Stem Cells International · 2019
23 Studies Reviewed to Assess Stem Cell Safety and Results
Researchers examined all available clinical evidence on "minimally manipulated" stem cell treatments for knee osteoarthritis. They reviewed 23 published studies—10 using bone marrow concentrate and 13 using fat-derived cells. This comprehensive review helps patients understand what science currently shows about these regenerative options.
Two Main Sources of Healing Cells Show Promise
The review compared two approaches for harvesting your body's natural healing cells. Bone marrow aspirate concentrate (BMAC) comes from your hip bone through a needle. Stromal vascular fraction (SVF) comes from fat tissue through a gentle liposuction procedure. Both contain mesenchymal stem cells—regenerative cells that can help repair damaged tissue. Lipogems® uses a similar fat-based approach but with gentler processing that preserves the tissue's natural structure.
Both Treatment Types Appear Safe for Patients
Across all 23 studies, researchers found no major safety concerns with either treatment approach. Patients experienced typical minor side effects like temporary swelling or discomfort at the treatment site. This safety profile is encouraging for patients seeking alternatives to surgery or long-term medication use. The procedures use your own tissue, eliminating risks of rejection or disease transmission.
Short-Term Pain Relief Observed in Multiple Studies
Patients in these studies generally reported meaningful improvements in pain and function. Benefits typically appeared within weeks to months after treatment. However, the researchers noted that long-term results beyond one to two years remain unclear. More extended follow-up studies are needed to understand how long benefits may last.
Study Quality Limits Strength of Conclusions
The researchers found that most studies had significant limitations. Only four of the 23 studies were randomized controlled trials—the gold standard for medical research. The modified Coleman score (a measure of study quality) revealed generally poor methodology across the literature. Studies used different preparation methods, cell quantities, and treatment protocols. This variation makes comparing results difficult and prevents firm treatment recommendations.
Fat-Derived Cells Gaining Research Attention
Thirteen studies focused specifically on adipose-derived (fat-derived) treatments like those used in Lipogems®. Researchers noted growing interest in fat as a cell source because it contains abundant regenerative cells. Fat tissue is easier to harvest than bone marrow and causes less discomfort. The processing can happen right in the operating room, making treatment more practical.
More High-Quality Research Still Needed
The review concludes that current evidence supports the safety of these treatments. Short-term benefits appear real, but stronger studies are necessary. Researchers call for standardized protocols so future studies can be compared meaningfully. They also emphasize the need for randomized trials with longer follow-up periods.
For patients considering Lipogems®, this review confirms that fat-derived regenerative treatments represent a scientifically studied option. The procedure's safety profile and promising short-term results make it worth discussing with your physician. While researchers continue gathering evidence, many patients have found relief through these minimally invasive approaches when other conservative treatments have failed.
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Source: Di Matteo et al., Stem Cells International, 2019.
Original Publication
Minimally Manipulated Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis: A Systematic Review of Clinical Evidence
B. Di Matteo, F. Vandenbulcke, N. D. Vitale, F. Iacono, K. Ashmore, M. Marcacci, E. Kon · Stem Cells International · 2019
The use of laboratory-expanded mesenchymal stem cells (MSCs) is subject to several restrictions, resulting in 'minimal manipulation' methods becoming the current most popular strategy to increase the use of MSCs in an orthopaedic practice. The aim of the present systematic review is to assess the clinical applications of 'minimally' manipulated MSCs, either as bone marrow aspirate concentrate (BMAC) or as stromal vascular fraction (SVF), in the treatment of knee osteoarthritis (OA). A systematic review of three databases (PubMed, ScienceDirect, and Google Scholar) was performed using the following keywords: 'Knee Osteoarthritis' with '(Bone marrow aspirate) OR (bone marrow concentrate)' or with '(adipose-derived mesenchymal stem cells) OR (adipose derived stromal cells) OR (stromal vascular fraction) OR (SVF)' as either keywords or MeSH terms. The reference lists of all retrieved articles were further reviewed for identification of potentially relevant studies. Twenty-three papers were included in the final analysis (10 on BMAC and 13 on SVF). Of these, only 4 were randomized controlled trials (RCTs). Bias risk evaluation, performed using a modified Coleman score, revealed an overall poor quality of the studies. In terms of clinical application, despite the apparent safety of minimally manipulated MSCs and the short-term positive clinical outcomes associated with their use, clinicians reported different preparation and administration methods, ranging from single intra-articular injections to intraosseous applications to administration in combination with other surgical procedures. The available literature is undermined by both the lack of high-quality studies and the varied clinical settings and different protocols reported in the few RCTs presently published. This prevents any recommendation on the use of either product in a clinical practice. Nevertheless, the use of minimally manipulated MSCs (in the form of BMAC or SVF) has been shown to be safe and have some short-term beneficial effects.