Foot and Ankle Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy.
Br Med Bull. 2017 Dec 1;124(1):31-54. doi: 10.1093/bmb/ldx030.
To examine the current literature regarding the clinical application of adipose-derived stem cells (ADSCs) for the management of orthopaedic pathologies.
MEDLINE,SCOPUS, CINAHL and EMBASE (1950 to April 14, 2017) were searched by two independent investigators for articles published in English. Reviews, meta-analyses, expert opinions, case reports, mini case series and editorials were excluded. Furthermore, we excluded animal studies, cadaveric studies and in vitro studies.
ADSCs seem to produce excellent clinical results. However, the length and modalities of follow-up in the different conditions are extremely variable. Nevertheless, it appears that the use of adipose-derived stem cells is associated with subjective and objective clinical improvements and minimal complication rates.
None of the studies identified is a randomized double-blinded trial, and most of the selected studies present major limitations, and different methods, confounding the results of our review.
It is necessary to conduct more and better studies to ascertain whether ADSCs really play a role in orthopaedic surgery with particular attention to ADSCs harvesting method, type of administration and the conditions treated.
The current literature regarding the use of ADSCs for orthopaedic pathologies is limited. At present, long-term safety is the biggest challenge of ADSCs based regenerative medicine.
Level IV-Study of Level I, II, III, IV.
研究脂肪干细胞（ADSCs）在骨科疾病治疗中的临床应用的现有文献。
通过两名独立研究人员，对 MEDLINE、SCOPUS、CINAHL 和 EMBASE（1950 年至 2017 年 4 月 14 日）进行了检索，以寻找发表在英语期刊上的文章。排除综述、荟萃分析、专家意见、病例报告、小型病例系列和社论。此外，我们还排除了动物研究、尸体研究和体外研究。
ADSCs 似乎产生了极好的临床效果。然而，不同情况下的随访时间和方式差异很大。然而，使用脂肪源性干细胞似乎与主观和客观的临床改善以及最小的并发症发生率有关。
所确定的研究均不是随机双盲试验，所选的大多数研究都存在重大局限性，并且不同的方法使我们的综述结果复杂化。
有必要进行更多和更好的研究，以确定 ADSCs 是否真的在骨科手术中发挥作用，特别要注意 ADSCs 的采集方法、给药类型和治疗的疾病。
目前关于 ADSCs 治疗骨科疾病的文献有限。目前，ADSCs 基于再生医学的长期安全性是最大的挑战。
IV 级-对 I、II、III、IV 级研究的研究。
