Abstract

Recently, Adipose-Derived Stem Cells (ADSCs) have been identified as potential therapeutic solutions for treating musculoskeletal disorders. However, the use of culture expanded ADSCs and ADSCs obtained by traditional enzymatic digestions which is otherwise known as Stromal Vascular Fraction (SVF) is strictly regulated by complicated legislation. Thus, several attempts have been made to isolate ADSCs through mechanical/non-enzymatic methods and without expansion at the point of care, leading to the development of minimally manipulated products-mechanically isolated SVF and Microfragmented Adipose Tissue (MFAT). Notably, although several studies documented the safety and efficacy of ADSCs for treating musculoskeletal diseases, the majority of them focused on culture expanded ADSCs rather than uncultured ADSCs (MFAT or SVF). To date, randomized controlled trials that have compared uncultured ADSCs with orthobiologics (hyaluronic acid, autologous blood derivates, and bone marrow concentrate) are limited. This review article aimed to provide a comprehensive review of randomized controlled trials that evaluated the safety and efficacy of uncultured ADSCs for treating musculoskeletal disorders while directing the reader’s attention towards heterogeneity in MFAT and SVF processing methods, characterization of stem cells, injectable dose, and techniques, and inconsistencies in reported clinical and imaging outcomes.

Keywords:Achilles tendinopathy; Microfragmented adipose tissue; Osteoarthritis; Stromal vascular fraction; Temporomandibular joint disease; Uncultured adipose-derived stem cells