SPECIAL ARTICLE   Free access

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2023 December;182(12):995-1002

DOI: 10.23736/S0393-3660.23.05381-0

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Adipose derived stem cells versus micro-fragmented adipose tissue in cartilage tissue regeneration and repair

Beatrice CASTIGLIONI ¹, Massimiliano LEIGHEB ², Michela BOSETTI ¹ ✉

¹ Division of Human Anatomy, Department of Pharmaceutical Science, University of Eastern Piedmont, Novara, Italy; ² Division of Orthopedics and Traumatology, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy

In recent years, the aim of regenerative medicine strategies is to develop therapeutic conservative approaches for the treatment of musculoskeletal injuries. Among these, the use of adult mesenchymal stem cells (MSCs) has represented the main instrument for the treatment of cartilage lesions in osteoarthritis, considered as chronic degenerative diseases with little chance of therapy. MSCs have shown promising cartilage repair from in-vitro, in-vivo, and clinical studies thanks to their self-renewing potential and multilineage differentiation capability, better if included in a 3D autologous scaffold. Adipose tissue could be considered an optimal source of stem cells called adipose derived stem cells (ADSCs) being a tissue easily available in large amounts and obtained through minus invasive procedures than others, but it has not to be underestimated the limits before implantation: in-vitro step variability, cell expansion, destruction of the original tissue with the loss of cells natural niche and of their long-term efficacy. To overcome this issue, lipoaspirate clusters, also called micro-fragmented adipose tissue (MFAT), provide stem cells in an intact stromal vascular niche with a high regenerative capacity. This review provides a comparative view of stem cells and lipoaspirate in terms of their sources, structure, properties and regenerative capacity. Moreover, are reviewed the most representative scientific papers showing in-vitro, in-vivo, and clinical results comparing ADSCs versus MFAT in the treatment of degenerative and inflammatory cartilage disease.

KEY WORDS: Guided tissue regeneration; Stem cells; Adipose tissue; Cartilage