自体脂肪干细胞治疗老年人膝关节骨关节炎的安全性和有效性：系统综述

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-07 DOI:10.1016/j.jcot.2024.102804

Biagio Zampogna , Francesco Rosario Parisi , Augusto Ferrini , Andrea Zampoli , Giuseppe Francesco Papalia , Saseendar Shanmugasundaram , Rocco Papalia

{"title":"自体脂肪干细胞治疗老年人膝关节骨关节炎的安全性和有效性：系统综述","authors":"Biagio Zampogna , Francesco Rosario Parisi , Augusto Ferrini , Andrea Zampoli , Giuseppe Francesco Papalia , Saseendar Shanmugasundaram , Rocco Papalia","doi":"10.1016/j.jcot.2024.102804","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Osteoarthritis (OA) is a progressive joint disease, and over 240 million people suffer from symptomatic OA, primarily in the knee, and mainly affects the elderly population over 65. A combination of different risk factors leads to biological changes in the microenvironments of the joints, causing cartilage overload and chondrocyte aging. Adipose-derived MSCs (ADSCs) are demonstrated to improve joint environments with an effective therapy for Knee OA. This review focused on patients over 65 years old to evaluate the effectiveness of ADSC therapies in treating KOA in elderly patients and demonstrate that complications are not higher in this cohort of patients.</div></div><div><h3>Materials and methods</h3><div>We conducted a bibliography search through the PubMed, Scopus, and Cochrane databases for English-language and human clinical trials published until Feb 7, 2024. We extracted the following study characteristics: Authors, year of publication, type of study, number of patients, number of knees, sex, Kellgren-Lawrence classification, culture ADSC, Number of cells injected, mean follow-up, adverse events, significant complications, and clinical outcomes data were extracted recorded and analyzed.</div></div><div><h3>Results</h3><div>According to inclusion criteria, seven clinical trials on autologous adipose-derived stem cells were considered. Four studies analyzed stem cells as a stromal vascular fraction (SVF), two as ADSC cultured, and 1 study investigated the MAT procedure. All studies reported improved clinical outcomes using autologous adipose-derived stem cells, on 339 knees. Post-treatment increased KOOS, WOMAC, IKS, VAS, and Lysholm knee scores were highlighted. All studies showed an improvement in all outcomes scores, and regarding complications, only 44 knees underwent adverse events, but no significant complications were found in all the studies reported.</div></div><div><h3>Conclusions</h3><div>The current systematic review demonstrated that using autologous adipose-derived stem cells improved clinical outcomes and is effective and safe in elderly patients. Additionally, this study will encourage orthopedic surgeons not to consider surgery as the only solution in elderly patients who are refractory to treatment and do not show end-stage knee osteoarthritis.</div></div><div><h3>Level of evidence</h3><div>Level IV, systematic review of level IV studies<strong>.</strong></div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"59 ","pages":"Article 102804"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Safety and efficacy of autologous adipose-derived stem cells for knee osteoarthritis in the elderly population: A systematic review\",\"authors\":\"Biagio Zampogna , Francesco Rosario Parisi , Augusto Ferrini , Andrea Zampoli , Giuseppe Francesco Papalia , Saseendar Shanmugasundaram , Rocco Papalia\",\"doi\":\"10.1016/j.jcot.2024.102804\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Osteoarthritis (OA) is a progressive joint disease, and over 240 million people suffer from symptomatic OA, primarily in the knee, and mainly affects the elderly population over 65. A combination of different risk factors leads to biological changes in the microenvironments of the joints, causing cartilage overload and chondrocyte aging. Adipose-derived MSCs (ADSCs) are demonstrated to improve joint environments with an effective therapy for Knee OA. This review focused on patients over 65 years old to evaluate the effectiveness of ADSC therapies in treating KOA in elderly patients and demonstrate that complications are not higher in this cohort of patients.</div></div><div><h3>Materials and methods</h3><div>We conducted a bibliography search through the PubMed, Scopus, and Cochrane databases for English-language and human clinical trials published until Feb 7, 2024. We extracted the following study characteristics: Authors, year of publication, type of study, number of patients, number of knees, sex, Kellgren-Lawrence classification, culture ADSC, Number of cells injected, mean follow-up, adverse events, significant complications, and clinical outcomes data were extracted recorded and analyzed.</div></div><div><h3>Results</h3><div>According to inclusion criteria, seven clinical trials on autologous adipose-derived stem cells were considered. Four studies analyzed stem cells as a stromal vascular fraction (SVF), two as ADSC cultured, and 1 study investigated the MAT procedure. All studies reported improved clinical outcomes using autologous adipose-derived stem cells, on 339 knees. Post-treatment increased KOOS, WOMAC, IKS, VAS, and Lysholm knee scores were highlighted. All studies showed an improvement in all outcomes scores, and regarding complications, only 44 knees underwent adverse events, but no significant complications were found in all the studies reported.</div></div><div><h3>Conclusions</h3><div>The current systematic review demonstrated that using autologous adipose-derived stem cells improved clinical outcomes and is effective and safe in elderly patients. Additionally, this study will encourage orthopedic surgeons not to consider surgery as the only solution in elderly patients who are refractory to treatment and do not show end-stage knee osteoarthritis.</div></div><div><h3>Level of evidence</h3><div>Level IV, systematic review of level IV studies<strong>.</strong></div></div>\",\"PeriodicalId\":53594,\"journal\":{\"name\":\"Journal of Clinical Orthopaedics and Trauma\",\"volume\":\"59 \",\"pages\":\"Article 102804\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-11-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Orthopaedics and Trauma\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0976566224004739\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Orthopaedics and Trauma","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0976566224004739","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

导言骨关节炎（OA）是一种进行性关节疾病，超过 2.4 亿人患有无症状的骨关节炎，主要发生在膝关节，主要影响 65 岁以上的老年人群。不同风险因素的综合作用导致关节微环境发生生物变化，造成软骨超负荷和软骨细胞老化。脂肪来源间充质干细胞（ADSCs）被证明能改善关节环境，是治疗膝关节OA的有效疗法。本综述重点关注 65 岁以上的患者，以评估 ADSC 疗法治疗老年患者 KOA 的有效性，并证明该类患者的并发症并不高。材料与方法我们通过 PubMed、Scopus 和 Cochrane 数据库对 2024 年 2 月 7 日之前发表的英语人类临床试验进行了文献检索。我们提取了以下研究特征：作者、发表年份、研究类型、患者人数、膝关节数量、性别、Kellgren-Lawrence分类、培养ADSC、注射细胞数量、平均随访时间、不良事件、重大并发症和临床结果数据均被提取记录并进行分析。四项研究分析了作为基质血管成分（SVF）的干细胞，两项研究分析了培养的ADSC，一项研究调查了MAT程序。所有研究均报告称，使用自体脂肪衍生干细胞可改善339个膝关节的临床疗效。研究强调了治疗后KOOS、WOMAC、IKS、VAS和Lysholm膝关节评分的提高。在并发症方面，只有44个膝关节发生了不良事件，但在所有报告的研究中均未发现明显的并发症。结论目前的系统综述表明，使用自体脂肪衍生干细胞可改善老年患者的临床疗效，且有效、安全。此外，这项研究将鼓励骨科医生不要将手术作为治疗难治且未显示出终末期膝骨关节炎的老年患者的唯一解决方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Safety and efficacy of autologous adipose-derived stem cells for knee osteoarthritis in the elderly population: A systematic review

Introduction

Osteoarthritis (OA) is a progressive joint disease, and over 240 million people suffer from symptomatic OA, primarily in the knee, and mainly affects the elderly population over 65. A combination of different risk factors leads to biological changes in the microenvironments of the joints, causing cartilage overload and chondrocyte aging. Adipose-derived MSCs (ADSCs) are demonstrated to improve joint environments with an effective therapy for Knee OA. This review focused on patients over 65 years old to evaluate the effectiveness of ADSC therapies in treating KOA in elderly patients and demonstrate that complications are not higher in this cohort of patients.

Materials and methods

We conducted a bibliography search through the PubMed, Scopus, and Cochrane databases for English-language and human clinical trials published until Feb 7, 2024. We extracted the following study characteristics: Authors, year of publication, type of study, number of patients, number of knees, sex, Kellgren-Lawrence classification, culture ADSC, Number of cells injected, mean follow-up, adverse events, significant complications, and clinical outcomes data were extracted recorded and analyzed.

Results

According to inclusion criteria, seven clinical trials on autologous adipose-derived stem cells were considered. Four studies analyzed stem cells as a stromal vascular fraction (SVF), two as ADSC cultured, and 1 study investigated the MAT procedure. All studies reported improved clinical outcomes using autologous adipose-derived stem cells, on 339 knees. Post-treatment increased KOOS, WOMAC, IKS, VAS, and Lysholm knee scores were highlighted. All studies showed an improvement in all outcomes scores, and regarding complications, only 44 knees underwent adverse events, but no significant complications were found in all the studies reported.

Conclusions

The current systematic review demonstrated that using autologous adipose-derived stem cells improved clinical outcomes and is effective and safe in elderly patients. Additionally, this study will encourage orthopedic surgeons not to consider surgery as the only solution in elderly patients who are refractory to treatment and do not show end-stage knee osteoarthritis.

Level of evidence

Level IV, systematic review of level IV studies.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.