Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence

Purpose: The association of adipose tissue-derived injectable products with platelet-rich plasma (PRP) has been promoted for osteoarthritis (OA) treatment. The aim of this study was to investigate the preclinical and clinical evidence supporting the potential of this combined approach to treat OA....

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Main Authors: Simone Orazi, Angelo Boffa, Manuela Salerno, Lucia Angelelli, Stefano Zaffagnini, Giuseppe Filardo
Format: Article
Language:English
Published: Bioscientifica 2024-11-01
Series:EFORT Open Reviews
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Online Access:https://eor.bioscientifica.com/view/journals/eor/9/11/EOR-24-0050.xml
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author Simone Orazi
Angelo Boffa
Manuela Salerno
Lucia Angelelli
Stefano Zaffagnini
Giuseppe Filardo
author_facet Simone Orazi
Angelo Boffa
Manuela Salerno
Lucia Angelelli
Stefano Zaffagnini
Giuseppe Filardo
author_sort Simone Orazi
collection DOAJ
description Purpose: The association of adipose tissue-derived injectable products with platelet-rich plasma (PRP) has been promoted for osteoarthritis (OA) treatment. The aim of this study was to investigate the preclinical and clinical evidence supporting the potential of this combined approach to treat OA. Methods: A systematic review was performed in January 2024 on five databases (PubMed, Embase, Scopus, Cochrane, and Web-of-Science) to identify preclinical in vivo and clinical studies. Safety, OA biomarker changes, and outcomes in terms of clinical and imaging results were analyzed. The quality of studies was assessed with the SYRCLE’s tool for preclinical studies and the Downs and Black checklist for clinical studies. Results: Ten preclinical studies (223 animals) and 14 clinical studies (594 patients) were included. Preclinical results documented improvements at the cartilage histological and immunohistochemical evaluation and at the biomarkers level. Clinical studies confirmed the procedure’s safety, and the case series suggested satisfactory results in different joints in terms of symptoms and function improvement, with positive findings at the biomarker level. However, the randomized controlled trials did not document any clinical benefit, nor any changes in the imaging analysis. A large heterogeneity and overall poor quality were documented in both preclinical and clinical studies. Conclusions: There is an increasing interest in the use of adipose tissue-derived injectable products associated with PRP for the treatment of OA joints, with preclinical studies showing promising results with this combined approach. However, clinical studies did not confirm the benefits offered by PRP augmentation to adipose tissue-derived injectable products in patients affected by OA.
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spelling doaj-art-e8e8cdc1a8ae4a4bb8d79b1258a81c652024-11-11T07:04:33ZengBioscientificaEFORT Open Reviews2058-52412024-11-0191110231033https://doi.org/10.1530/EOR-24-0050Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidenceSimone Orazi0Angelo Boffa1Manuela Salerno2Lucia Angelelli3Stefano Zaffagnini4Giuseppe Filardo5Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyClinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyApplied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyClinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyClinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyDepartment of Surgery, Service of Orthopaedics and Traumatology, EOC, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland Purpose: The association of adipose tissue-derived injectable products with platelet-rich plasma (PRP) has been promoted for osteoarthritis (OA) treatment. The aim of this study was to investigate the preclinical and clinical evidence supporting the potential of this combined approach to treat OA. Methods: A systematic review was performed in January 2024 on five databases (PubMed, Embase, Scopus, Cochrane, and Web-of-Science) to identify preclinical in vivo and clinical studies. Safety, OA biomarker changes, and outcomes in terms of clinical and imaging results were analyzed. The quality of studies was assessed with the SYRCLE’s tool for preclinical studies and the Downs and Black checklist for clinical studies. Results: Ten preclinical studies (223 animals) and 14 clinical studies (594 patients) were included. Preclinical results documented improvements at the cartilage histological and immunohistochemical evaluation and at the biomarkers level. Clinical studies confirmed the procedure’s safety, and the case series suggested satisfactory results in different joints in terms of symptoms and function improvement, with positive findings at the biomarker level. However, the randomized controlled trials did not document any clinical benefit, nor any changes in the imaging analysis. A large heterogeneity and overall poor quality were documented in both preclinical and clinical studies. Conclusions: There is an increasing interest in the use of adipose tissue-derived injectable products associated with PRP for the treatment of OA joints, with preclinical studies showing promising results with this combined approach. However, clinical studies did not confirm the benefits offered by PRP augmentation to adipose tissue-derived injectable products in patients affected by OA. https://eor.bioscientifica.com/view/journals/eor/9/11/EOR-24-0050.xmladipose tissuecartilageorthobiologicsosteoarthritisplatelet-rich plasma
spellingShingle Simone Orazi
Angelo Boffa
Manuela Salerno
Lucia Angelelli
Stefano Zaffagnini
Giuseppe Filardo
Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence
EFORT Open Reviews
adipose tissue
cartilage
orthobiologics
osteoarthritis
platelet-rich plasma
title Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence
title_full Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence
title_fullStr Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence
title_full_unstemmed Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence
title_short Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence
title_sort adipose tissue derived injectable products combined with platelet rich plasma for the treatment of osteoarthritis the promising preclinical results are not confirmed by the clinical evidence
topic adipose tissue
cartilage
orthobiologics
osteoarthritis
platelet-rich plasma
url https://eor.bioscientifica.com/view/journals/eor/9/11/EOR-24-0050.xml
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