Table 2.

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

Experimental model	Treatment groups	Evaluations	Results	Ref.
In vitro: Human chondrocytes (2 × 105) from healthy donors hSVF or hADSCs (2 × 105) from abdomen In vivo: 10 BALB/C nude mice (6 wks) with subcutaneous pouches Allogenic SVF or ADSCs Allogenic chondrocytes (1 × 107)	In vitro: Group 1: SVF pellet Group 2: ADSC pellet Group 3: chondrocyte pellet Group 4: SVF+chondrocyte pellet (4 : 1) Group 5: ADSCs+chondrocyte pellet (4 : 1) In vivo: Group 1: no treatment Group 2: SVF+chondrocytes (4 : 1) in 2% alginate Group 3: ADSCs+chondrocytes (4 : 1) in 2% alginate Group 4: chondrocytes	In vitro: Histology GAG quantification Cell proliferation In vivo: Histology GAG quantification IHC (COLL II)	In vitro: 1 mo Group 4: ↑ GAG, chondrocytes % than group 5 In vivo: 2 mo Group 2: ↑ GAG, COLL II protein than groups 1, 3, and 4	[43]
In vivo: 8 skeletally mature Dutch milk goats (82.4 ± 11.7 kg) with 2 osteochondral defects in the right troclea femoris and 2 defects in the right medial femoral condyles Autologous SVF or ADSCs (5 × 106) COLL I/COLL III scaffold (5 × 3 mm)	Group 1: scaffold Group 2: scaffold+SVF Group 3: scaffold+ADSCs	Gross evaluations Histology Micro-CT	1 mo Group 1: =gross appearance score, histological score than groups 2 and 3. 4 mo Group 2: ↑ cartilage and SB regeneration than groups 1 and 3 Group 2: ↑ hyaline cartilage; ↓ fibrocartilage, cartilaginous tissue in SB than group 3	[44]
In vivo: 30 small tail Han sheep (6 mo) with OA in the right knee Autologous SVF (1 × 107) or ADSCs from cervicothoracic region HA scaffold (600–1500 kDa) (2.5 ml)	Group 1: saline (5 ml) Group 2: scaffold Group 3: scaffold+ADSCs (1 × 107) Group 4: scaffold+ADSCs (5 × 107) Group 5: scaffold+SVF	IHC (COLL X, SDF1)	3 mo Group 5: ↓ COLL X protein than groups 3 and 4. Group 5: ↑ SDF1 protein than groups 1 and 2	[7]
In vivo: 9 NOD/SCID mice with injured cartilage hSVF (2 × 106) from abdomen	Group 1: PBS Group 2: SVF+PRP	Movement recording Histology Histomorphometry	45 days Group 2: ↓ time required that mice could move, cartilage lesion area; ↑ formed neocartilage than group 1	[45]
Clinical trial: 13 pz (65-82 yrs) with bilateral severe OA Allogenic SVF (3 × 107) from abdomen	Group 1: SVF	Clinical evaluation	1 and 6 mo Group 1: ↓ JKOM score, WOMAC score, VAS score than presurgery. No differences between 1 and 6 mo	[46]
Clinical trial: 18 pz (59.6 ± 10.5 yrs) with OA Autologous SVF (35 ml) from abdomen	Group 1: SVF	Clinical evaluation Radiography	3, 6, and 18 mo Group 1: ↓ VAS score, WOMAC % than presurgery. No infection, thromboembolism, adverse reaction 18 mo Group 1: =outerbridge score than presurgery	[47]
Clinical trial: 10 pz (≥50 yrs) with idiopathic knee OA Allogenic SVF (5 ml) from abdomen	Group 1: SVF+PRP (3 ml)	Clinical evaluation SF analysis	3, 6, 12, 18, and 24 mo Group 1: ↓ WOMAC total, WOMAC stiffness, WOMAC pain, WOMAC physical function; ↑ six-minute walk distance than presurgery 24 mo Group 1: no atypical cells in SF, restore SF properties, synovial metabolism; ↓ cartilage pathology than presurgery	[48]
Clinical trial: 4 pz (23-74 yrs) with OA of both knees Autologous SVF (5 × 107, 6 × 107, 7.5 × 107, and 10 × 107) from periumbilical region	Group 1: SVF+PRP (3 ml) (4 injections every month)	Clinical evaluation	12 mo Group 1: ↑ KOOS score pain, symptoms, ADL, sport/rec function, knee-related QOL. Pz regained normal functional activity	[49]
Clinical trial: 30 pz (>18 yrs) with OA Autologous SVF from abdomen	Group 1: arthroscopic microfracture Group 2: arthrosopic microfracture+SVF+PRP (5 ml)	Clinical evaluation BM edema	12 mo Group 2: ↓ BM edema than group 1 Group 1: ↓ WOMAC score during time 18 mo Group 2: ↓ WOMAC score during time Group 2: ↓ WOMAC score; ↑ Lysholm score than group 1	[50]
Clinical trial: 33 pz (>38 yrs) with OA Autologous SVF (6 ml with 90‐120 × 106 cells) from abdomen	Group 1: arthroscopic microfracture Group 2: arthroscopic microfracture+SVF	Clinical evaluation BM edema	12 mo Groups 1 and 2: ↓ VAS score, WOMAC score during time 24 mo Group 2: ↓ VAS score, WOMAC score, Outerbridge score than group 1 Groups 1 and 2: ↑ Lysholm score during time Group 2: ↓ BM edema during time Group 1: ↑ BM edema during time	[51]
Clinical trial: 16 pz (53 ± 10.97 yrs) with bilateral OA of grade II or III Hyaluronic acid (4 ml) Autologous SVF (4 ml) from abdomen	Group 1: arthroscopic debridement+SVF Group 2: arthroscopic debridement+HA	Clinical evaluation Radiography	1, 3, 6, and 12 mo Group 1: ↓ VAS, WOMAC pain, WOMAC stiffness; ↑ ROM during time Group 2: ↑ VAS, WOMAC pain, WOMAC stiffness; ↓ ROM than group 1 1 mo Group 2: ↑ ROM during time 3, 6, and 12 mo Group 2: ↓ ROM during time 1 and 3 mo Group 2: ↓ VAS during time 6 and 12 mo Group 2: ↑ VAS during time Group 1: ↑ MOCART score during time Group 1: ↑ MOCART score, complete tissue filling than group 2 Group 2: ↓ MOCART score during time	[52]
Clinical trial: 26 pz (46.1 ± 12.2 yrs) with full-thickness chondral defect of the talar dome Autologous SVF (3.94 × 106 MSCs) from buttock	Group 1: arthroscopic marrow stimulation Group 2: arthroscopic marrow stimulation+SVF	Clinical evaluation Radiography	16-25 mo Groups 1 and 2: ↓ VAS score; ↑ AOFAS score during time Group 2: ↓ VAS score; ↑ AOFAS score, Tegner score, MOCART score than group 2	[53]
Clinical trial: 1 pz (36 yrs) with traumatic osteochondral lesion of the right medial femoral condyle 8 mo after injury Autologous SVF (1.5 × 106) from abdomen	Group 1: microfracture+SVF	Clinical evaluation BM edema Radiography	24 mo Group 1: ↑ IKDC, EQ-VAS than presurgery 12 and 24 mo Group 1: recovery of CT; ↓ BM edema than presurgery	[54]