Review Article

Stromal Vascular Fraction and Amniotic Epithelial Cells: Preclinical and Clinical Relevance in Musculoskeletal Regenerative Medicine

Table 3

In vitro, in vivo, and clinical studies on SVF in tendon regeneration.

Experimental modelTreatment groupsEvaluationsResultsRef

In vivo:
20 adult NZW rabbits (2.5-3 kg) with complete transaction of DDFT midsubstance
Allogenic SVF () from inguinal region
Group 1: PBS (0.2 ml)
Group 2: SVF
Histology
Histomorphometry
IHC (COLL I, COLL III)
Biomechanics
2 mo
Group 2: ↑ fibrillar linearity, fibrillar continuity, COLL I protein, ultimate load, energy absorption, stiffness; ↓ no. of capillaries in neotendon, COLL III protein than group 1
[55]

In vivo:
36 adult NZW rabbits (2.5-3 kg) with a complete transaction through the central one third of flexor tendon
Allogenic SVF () from inguinal region
Allogenic BMSCs () from iliac crest
Group 1: PBS (0.2 ml)
Group 2: SVF
Group 3: BMSCs
Biomechanics3 and 8 wks
Groups 2 and 3: ↑ energy absorption, ultimate load, ultimate stress, yield load, stiffness than group 1
[56]

In vivo:
36 adult NZW rabbits (2-2.5 kg) with supraspinatus tendon severed from the great trochanter
Autologous SVF from inguinal region
Group 1: FG (1 ml)
Group 2: SVF+FG (1 ml)
Radiography
Biomechanics
1 mo
Group 2: ↑ maximum load, maximum strength than group 1
2 mo
Group 2: ↑ maximum load, maximum strength, stiffness than group 1
3 mo
Group 2: ↑ SNQ, stiffness than group 1
[57]

In vivo:
36 NZW rabbits (2-2.5 kg) with bilateral supraspinatus tendon severed from the great trochanter
Autologous SVF from inguinal region
Group 1: FG (1 ml)
Group 2: SVF+FG (1 ml)
Histology
IHC (COLL I, COLL III, BMP2)
Histomorphometry
Biomechanics
2 mo
Group 2: ↑ tendon-bone healing maturity, COLL I, COLL III, COLL I/COLL III, BMP2 protein, maximum load, maximum strength, stiffness than group 1
[58]

Clinical trial:
43 pz (29-55 yrs) with unilateral or bilateral NIAT
Allogenic SVF (4 ml) from abdomen
Group 1: PRP (4 ml)
Group 2: SVF
Radiography
Clinical evaluation
6 mo
Groups 1 and 2: ↓ VAS; ↑ MR size, US size, PD than presurgery
Group 1: ↓ MR-Si than group 2
[59]

Clinical trial:
44 pz (18-55 yrs) with unilateral or bilateral chronic tendinopathy of the Achilles tendon
Allogenic SVF (4 ml) from abdomen
Group 1: PRP (4 ml)
Group 2: SVF
Clinical evaluation2 wks, 1 mo, 4 mo, and 6 mo
Groups 1 and 2: ↓ VAS pain scale; ↑ VISA-A score, AOFAS score, SF-36 than presurgery
2 wks
Group 2: ↓ VAS pain scale; ↑ VISA-A score, AOFAS score than group 1
1 mo
Group 2: ↓ VAS pain scale than group 1
[60]