J Knee Surg 2019; 32(01): 055-064
DOI: 10.1055/s-0038-1672155
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adipose-Based Therapies for Knee Pain—Fat or Fiction

Yoshiharu Shimozono
1  Foot and Ankle Service, Hospital for Special Surgery, New York, New York
Lisa A. Fortier
2  Department of Clinical Sciences, Cornell University, Ithaca, New York
Donald Brown
3  Department of Orthobiologics, Isto Biologics, Hopkinton, Massachusetts
John G. Kennedy
1  Foot and Ankle Service, Hospital for Special Surgery, New York, New York
› Author Affiliations
Further Information

Publication History

10 July 2018

15 August 2018

Publication Date:
30 November 2018 (online)


Regenerative cell therapies are emerging as promising treatments for numerous musculoskeletal conditions, including knee osteoarthritis (OA). Adipose-derived stem cells and possibly other adipose-based therapies have a greater chondrogenic potential than stem cells derived from bone marrow, and thus a lot of attention is being placed on them as potential regenerative agents in the treatment of knee OA. Several types of adipose-based therapies have good basic science and preclinical data supporting their translation to human therapeutic intervention. Cultured, adipose-derived stem cells appear to be good source of bioactive cells with convenient accessibility, relative abundance, and well-documented regenerative capacity. Non-culture expanded adipose-based therapy, in the forms of stromal vascular fraction and most recently micronized adipose tissue (MAT), have been utilized in patients to treat OA and other cartilage abnormalities with encouraging preliminary data. These adipose-based therapies have shown a lot of therapeutic potential; however, because of the regulatory restrictions on enzymatic isolation and cell expansion, only MAT is currently available in clinical practice in the United States. While no serious adverse reactions have been reported, adipose-derived therapies also have the potential for adverse reactions including inflammation and infection. The current review provides an update on the latest research and presents this evidence on the therapeutic potential of adipose-based therapies in the treatment of knee OA.