New Osteoarthritis Treatment Involves Fat Cells
A new osteoarthritis treatment is on the horizon, and it involves using a patient’s own fat cells. Word of the success of this new approach comes from a team in the Czech Republic.
About 27 million people in the United States alone have osteoarthritis. It is the most common joint disease in the world and tends to progress slowly.
This painful and debilitating degenerative disease is characterized by the breakdown of cartilage, which protects and cushions the joints. The result is pain, stiffness, loss of movement in the affected joints, and a reduced quality of life.
The new treatment approach, which is still under investigation, involves harvesting fat from a patient for his or her own stem cells. The cells can be obtained using standard liposuction.
The final product of the harvest is called stromal vascular fraction (SVF), which is composed of mesenchymal stem cells, growth factors, T cells, and other components. SVF cells are isolated from the loose connective tissue taken during a patient’s liposuction and then prepared for injection into the individual’s affected joints.
In this study, 1,114 patients with grade 2 to 4 degenerative osteoarthritis underwent liposuction for harvesting of SVF. A total of 1,856 joints (primarily hips and knees) were treated with a single dose of SVF, and all the individuals were followed for a median of 17.2 months (range, 12.2 to 54.3).
Factors such as pain, limping, joint movement range, use of nonsteroidal pain relievers, and stiffness were evaluated before treatment and at months 3, 6, and 12 after treatment. Here’s what the authors found:
- Improvement of at least 75 percent was noted in 63 percent of patients
- At least 50 percent improvement was documented in 91 percent of patients one year after treatment
- Obese patients and those with more severe osteoarthritis had slower healing
- Use of pain killers declined significantly after treatment
- No side effects were associated with treatment
Other treatments for osteoarthritis
The study’s authors compared SVF cell treatment with mesenchymal stem cell therapy taken from bone marrow, another approach that is under investigation for treatment of osteoarthritis. The authors noted that, among other advantages:
- SVF cells contain about 500 to 2,500 times more mesenchymal stem cells than can be harvested from bone marrow
- Fat tissue remains relatively stable over time while MSCs in bone marrow decline significantly as people age
- Fat tissues contain unique cells that have the ability to suppress inflammation
- SVF cells can be used immediately after they are isolated from fat tissues
The authors also noted that SVF treatment has advantages over surgical options for osteoarthritis, such as knee and hip replacements, which are often performed for this disease. These surgical procedures are not feasible for some patients because of concomitant health issues and/or age. They also are associated with a long recovery period and possible side effects, such as stroke, nerve damage, systemic infections, myocardial infarction, and death. No significant side effects have been noted with SVF.
Both over-the-counter and prescription medications are commonly used to relieve symptoms of osteoarthritis. These include nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen, celecoxib), analgesics (e.g., acetaminophen, opioids), and topicals (e.g., capsaicin). Injectable treatments, such as hyaluronic acid, are administered by healthcare providers and replace joint fluid. Corticosteroids can be taken orally or injected into the joints.
Lifestyle treatments for osteoarthritis include regular stretching, maintaining a healthy weight, regular exercise, and following a nutritious diet. Stress management techniques such as meditation, yoga (including laughter yoga), and deep breathing are important to help maintain a positive outlook. Natural remedies, including omega-3 fatty acids, Chinese medicine, glucosamine and chondroitin, cat's claw, and ginger, may be helpful as well.
The authors of the latest study noted that use of a patient’s own stromal vascular fraction cells for degenerative osteoarthritis is “safe, cost effective and clinically effective, and can lead to an improved quality of life.” However, they also pointed out that “there is no guarantee that this cell therapy can lead to a definite cure for degenerative OA.” More research is needed to answer these and other issues concerning this new osteoarthritis treatment.
Litwic A et al. Epidemiology and burden of osteoarthritis. British Medical Journal 2013; 105:185-199
Michalek J et al. Autologous adipose tissue-derived stromal vascular fraction cells application in patients with osteoarthritis. Cell Transplantation 2015 Jan 20 online