Management of knee osteoarthritis by combined stromal vascular fraction cell therapy, platelet-rich plasma, and musculoskeletal exercises: a case series

Abstract

Introduction

Knee osteoarthritis is associated with persistent joint pain, stiffness, joint deformities, ligament damage, and surrounding muscle atrophy. The complexity of the disease makes treatment difficult. There are no therapeutic drugs available to halt the disease progression, leaving patients dependent on pain medication, anti-inflammatory drugs, or invasive joint replacement surgery.

Case presentations

Four patients with a history of unresolved symptomatic knee osteoarthritis were investigated for the therapeutic outcome of combining an exercise rehabilitation program with intra-articular injections of autologous StroMed (ie, stromal vascular fraction cells concentrated by ultrasonic cavitation from lipoaspirate) and platelet-rich plasma (PRP). The Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS) was administered along with physical function tests over a 12-month period. The first patient achieved a maximum therapeutic outcome of 100 in all five KOOS subscales (left knee), and 100 for four subscales (right knee). The second patient scored 100 in all five KOOS subscales (left knee), and greater than 84 in all subscales (right knee). Treatment of the third patient resulted in improved outcomes in both knees of >93 for four KOOS subscales, and 60 for the Function in Sport and Recreation subscale. The fourth patient improved to 100 in all five KOOS subscales. In all patients, the physical function “Get-up and Go” test and “Stair Climbing Test” returned to normal (a value of zero).

Conclusion

This case series indicates that improved outcomes may be obtained when autologous stromal vascular fraction (StroMed) cell therapy is combined with traditional exercise practices and PRP for osteoarthritis. Of the seven joints treated: all patients’ scores of pain improved to >96; and quality of life scores to >93. Functional performance measures of mobility returned to normal. This simple treatment appears to be extremely effective for osteoarthritis disorders that have no drug treatment to halt disease progression.

Keywords:

• autologous stromal cell concentrate
• SVF
• StroMed
• mesenchymal stem cells
• pain
• joint

Acknowledgments

Written informed consent was obtained from the patients for publication of this case report and accompanying images.

Author contributions

Rod Diamond designed and supervised the exercise program. Nathan Gibbs, Rod Diamond, Eric O Sekyere, and Wayne D Thomas performed the procedures, collected the patient data, and assisted with completion of the manuscript. All authors contributed toward drafting and critically revising the paper, and read and approved the final manuscript.

Disclosure

The use of ultrasonic cavitation to obtain SVF from adipose is a filed patent by Cell-Innovations Pty Ltd. Wayne Thomas is a director and shareholder of Cell-Innovations Pty Ltd. The authors report no other conflicts of interest in this work.