As advocates for evidence-based medicine, we believe treatment decisions should be made on the basis of the best available scientific information whenever possible and we believe patients should have access to comprehensive information so that informed decisions can be made.
Below we list important research on the use of stem cell injections for musculoskeletal indications, along with a brief summary. Please note that while we strive to have as comprehensive and updated list as possible, we will direct your attention to the US National Library of Medicine for a more complete list of all published works.
Michalek J, Moster R, Lukac L, Proefrock K, Petrasovic M, Rybar J, Capkova M, Chaloupka A, Darinskas A, Michalek J Sr, Kristek J, Travnik J, Jabandziev P, Cibulka M, Holek M, Jurik M, Skopalik J, Kristkova Z, Dudasova Z.
Cell Transplant. 2015 Jan 20. doi: 10.3727/096368915X686760.
Multicenter case control study involving 1114 patients with osteoarthritis were injected with adipose tissue-derived stem cells (ADSCs) and followed up for a median of 17.2 months. There were no serious side effects. At 12 months of follow-up, 91% of patients had at least 50% improvement in symptoms and 63% of patients had at least 75% symptom improvement.
Koh YG, Jo SB, Kwon OR, Suh DS, Lee SW, Park SH, Choi YJ.
Arthroscopy. 2013 Apr;29(4):748-55.
18 patients with knee osteoarthritis had adipose tissue-derived stem cells (ADSCs) injected with calcium-chloride PRP after arthroscopic debridement. WOMAC, Lysholm and VAS clinical scores all improved. Whole-organ MRI score, especially cartilage whole-organ MRI score, also improved. There was clinical and MRI improvement.
Pak J, Lee JH, Park KS, Jeong BC, Lee SH.
Biores Open Access. 2016 Aug 1;5(1):192-200.
Case series with injections of autologous adipose tissue-derived stem cells (ADSCs) and homogenized extracellular matrix (ECM) in the form of adipose stromal vascular fraction (SVF), along with hyaluronic acid (HA) and platelet-rich plasma (PRP) activated by calcium chloride for knee osteoarthritis (OA) patients. All patients’ MRI data showed cartilage-like tissue regeneration. All clinical outcomes also improved.
Koh YG, Choi YJ, Kwon OR, Kim YS.
Am J Sports Med. 2014;42(7):1628–37.
35 patients (37 knee joints) with OA were injected with adipose tissue-derived stem cells (ADSCs) in combination with PRP. After mean follow-up period of 12.7 months, International Knee Documentation Committee (IKDC) and Tegner activity scale scores significantly improved in 94% of patients. There was abnormal repair tissue seen on second-look arthroscopies.
Bui KH-T, Duong TD, Nguyen NT, Nguyen TD, Le VT, Mai VT, Phan NL-C, Le DM, Ngoc NK, Pham PV.
Biomed Res Ther. 2014;1(1):2–8.
Case series involving 21 patients with grades 2-3 knee OA were treated with autologous ADSCs with PRP. All 21 patients showed improved joint function, VAS pain score and Lysholm score after 8.5 months. Additionally, significant increased cartilage thickness was noted on MRI.
Koh YG, Choi YJ, Kwon SK, Kim YS, Yeo JE.
Knee Surg Sports Traumatol Arthrosc. 2015;23(5):1308–16.
30 patients with knee OA were injected with adipose tissue-derived stem cells (ADSCs) in combination with PRP under arthroscopic guidance. At 2 years post-treatment, almost all patient showed significant improvement in KOOS outcome score, VAS pain scale and Lysholm score. On second-look arthroscopy, 63% of patients had improved cartilage, 25% had maintained cartilage and 12% had non-healing cartilage defects.
Randelli P, Randelli F, Ragone V, Menon A, D’Ambrosi R, Cucchi D, Cabitza P, Banfi G.
Biomed Res Int. 2014;2014:129515.
Stem cells therapies represent a novel frontier in the management of rotator cuff disease that required further basic and clinical research.
Saxer F, Scherberich A, Todorov A, Studer P, Miot S, Schreiner S, Güven S, Tchang LA, Haug M, Heberer M, Schaefer DJ, Rikli D, Martin I, Jakob M.
Stem Cells. 2016;34(12):2956–66.
Autologous adipose SVF was used with ceramic granules within fibrin gel to treat proximal humeral fractures in conjunction with standard open reduction and internal fixation in eight patients. Spontaneous bone tissue and vessel formation was demonstrated within the fracture microenvironment with autologous adipose SVF
Lee SY, Kim W, Lim C, Chung SG.
Stem Cells. 2015;33(10):2995–3005.
12 patients with lateral epicondylosis treated with allogeneic adipose-derived MSCs. The ADSCs were injected with fibrin glue under ultrasound guidance into the hypoechoic tendon lesions of chronic lateral epicondylosis. VAS score, modified Mayo clinic performance index, and longitudinal and transverse ultrasound images of the tendon defect areas were evaluated. Through 52 weeks of follow-up, VAS and elbow performance scores improved. Ultrasound evaluation of tendon defect also improved significantly and no significant adverse effects were observed.
de Girolamo L, Grassi M, Viganò M, Orfei CP, Montrasio UA, Usuelli F.
The Orthopaedic Journal of Sports Medicine. 2016;4(7):supplement 4.
Randomized prospective clinical trial involving 56 patients with Achilles tendinopathy. 28 patients were randomly assigned to a single autologous PRP injection and the other 28 patients were assigned to a single autologous adipose SVF injection. VAS, VISA-A, AOFAS and SF-36 improved in both groups at 4 and 6 months follow-up. In the adipose SVF injection patients, these improvements were faster and more pronounced. MRI and ultrasound studies showed no significant difference and there were no side effects in either group.