Francis Sam L, Yao Angela, Choong Peter F M
Department of Surgery, The University of Melbourne, Melbourne, VIC 3065, Australia.
Department of Orthopaedics, St Vincent's Hospital, Melbourne, VIC 3056, Australia.
Bioengineering (Basel). 2020 Jul 4;7(3):69. doi: 10.3390/bioengineering7030069.
Adipose tissue is a rich source of stem cells, which are reported to represent 2% of the stromal vascular fraction (SVF). The infrapatellar fat pad (IFP) is a unique source of tissue, from which human adipose-derived stem cells (hADSCs) have been shown to harbour high chondrogenic potential. This review aims to calculate, based on the literature, the culture time needed before an average knee articular cartilage defect can be treated using stem cells obtained from arthroscopically or openly harvested IFP. Firstly, a systematic literature review was performed to search for studies that included the number of stem cells isolated from the IFP. Subsequent analysis was conducted to identify the amount of IFP tissue harvestable, stem cell count and the overall yield based on the harvesting method. We then determined the minimum time required before treating an average-sized knee articular cartilage defect with IFP-derived hADSCs by using our newly devised equation. The amount of fat tissue, the SVF cell count and the stem cell yield are all lower in arthroscopically harvested IFP tissue compared to that collected using arthrotomy. As an extrapolation, we show that an average knee defect can be treated in 20 or 17 days using arthroscopically or openly harvested IFP-derived hADSCs, respectively. In summary, the systematic review conducted in this study reveals that there is a higher amount of fat tissue, SVF cell count and overall yield (cells/volume or cells/gram) associated with open (arthrotomy) compared to arthroscopic IFP harvest. In addition to these review findings, we demonstrate that our novel framework can give an indication about the culture time needed to scale up IFP-derived stem cells for the treatment of articular cartilage defects based on harvesting method.
脂肪组织是干细胞的丰富来源，据报道，干细胞占基质血管成分（SVF）的2%。髌下脂肪垫（IFP）是一种独特的组织来源，已证明从该组织中获取的人脂肪来源干细胞（hADSCs）具有很高的软骨生成潜力。本综述旨在根据文献计算，使用通过关节镜或开放手术获取的IFP来源的干细胞治疗平均大小的膝关节软骨缺损之前所需的培养时间。首先，进行了系统的文献综述，以寻找包含从IFP分离的干细胞数量的研究。随后进行分析，以确定可收获的IFP组织量、干细胞数量以及基于收获方法的总产量。然后，我们使用新设计的公式确定了用IFP来源的hADSCs治疗平均大小的膝关节软骨缺损之前所需的最短时间。与通过切开手术收集的IFP组织相比，通过关节镜收集的IFP组织中的脂肪组织量、SVF细胞数量和干细胞产量均较低。作为一种推断，我们表明，分别使用通过关节镜或开放手术获取的IFP来源的hADSCs，平均膝关节缺损可在20天或17天内得到治疗。总之，本研究进行的系统综述表明，与关节镜下IFP采集相比，开放手术（切开手术）相关的脂肪组织量、SVF细胞数量和总产量（细胞/体积或细胞/克）更高。除了这些综述结果外，我们还证明，我们的新框架可以根据收获方法给出扩大IFP来源干细胞用于治疗关节软骨缺损所需培养时间的指示。
