Intratendinous adipose-derived stromal vascular fraction (SVF) injection provides a safe, efficacious treatment for Achilles tendinopathy: results of a randomized controlled clinical trial at a 6-month follow-up

Federico Giuseppe Usuelli, Miriam Grassi, Camilla Maccario, Marco Vigano’, Luciano Lanfranchi, Umberto Alfieri Montrasio, Laura de Girolamo

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: Although platelet-rich plasma (PRP) injection has shown controversial results for the treatment of Achilles tendinopathy, it remains the most used biological treatment. Recent findings seem to demonstrate that the stromal vascular fraction (SVF) within adipose tissue may counteract the impaired tendon homeostasis. The aim of this study was to prospectively compare the efficacy of PRP and SVF injection for the treatment of non-insertional Achilles tendinopathy. Methods: Fourty-four patients were recruited in the study; 23 of them were assigned to the PRP group whereas 21 to the SVF group, treated unilaterally or bilaterally for a total of 28 tendons per group. All patients (age 18–55 years) were clinically assessed pre-operatively and at 15, 30, 60, 120 and 180 days from treatment, using the VAS pain scale, the VISA-A, the AOFAS Ankle-Hindfoot Score and the SF-36 form. The patients were also evaluated by ultrasound and magnetic resonance before treatment and after 4 (US only) and 6 months. Results: Both treatments allowed for a significant improvement with respect to baseline. Comparing the two groups, VAS, AOFAS and VISA-A scored significantly better at 15 and 30 days in the SVF in comparison to PRP group (p < 0.05). At the following time points the scores were not significantly different between the two groups. No correlation has been found between clinical and radiological findings. Conclusions: Both PRP and SVF were safe, effective treatments for recalcitrant Achilles tendinopathy. The patients treated with SVF obtained faster results, thus suggesting that such a treatment should be taken into consideration for those patients who require an earlier return to daily activities or sport. Level of evidence: Randomized Controlled Clinical Trial, Level 1.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
Publication statusAccepted/In press - Mar 1 2017

Fingerprint

Tendinopathy
Blood Vessels
Randomized Controlled Trials
Platelet-Rich Plasma
Injections
Therapeutics
Tendons
Ankle
Sports
Adipose Tissue
Homeostasis
Magnetic Resonance Spectroscopy
Pain

Keywords

  • Achilles tendinopathy
  • Achilles tendon
  • Adipose-derived mesenchymal stem cells
  • PRP
  • Stromal vascular fraction (SVF)

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Intratendinous adipose-derived stromal vascular fraction (SVF) injection provides a safe, efficacious treatment for Achilles tendinopathy : results of a randomized controlled clinical trial at a 6-month follow-up. / Usuelli, Federico Giuseppe; Grassi, Miriam; Maccario, Camilla; Vigano’, Marco; Lanfranchi, Luciano; Alfieri Montrasio, Umberto; de Girolamo, Laura.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 01.03.2017, p. 1-11.

Research output: Contribution to journalArticle

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abstract = "Purpose: Although platelet-rich plasma (PRP) injection has shown controversial results for the treatment of Achilles tendinopathy, it remains the most used biological treatment. Recent findings seem to demonstrate that the stromal vascular fraction (SVF) within adipose tissue may counteract the impaired tendon homeostasis. The aim of this study was to prospectively compare the efficacy of PRP and SVF injection for the treatment of non-insertional Achilles tendinopathy. Methods: Fourty-four patients were recruited in the study; 23 of them were assigned to the PRP group whereas 21 to the SVF group, treated unilaterally or bilaterally for a total of 28 tendons per group. All patients (age 18–55 years) were clinically assessed pre-operatively and at 15, 30, 60, 120 and 180 days from treatment, using the VAS pain scale, the VISA-A, the AOFAS Ankle-Hindfoot Score and the SF-36 form. The patients were also evaluated by ultrasound and magnetic resonance before treatment and after 4 (US only) and 6 months. Results: Both treatments allowed for a significant improvement with respect to baseline. Comparing the two groups, VAS, AOFAS and VISA-A scored significantly better at 15 and 30 days in the SVF in comparison to PRP group (p < 0.05). At the following time points the scores were not significantly different between the two groups. No correlation has been found between clinical and radiological findings. Conclusions: Both PRP and SVF were safe, effective treatments for recalcitrant Achilles tendinopathy. The patients treated with SVF obtained faster results, thus suggesting that such a treatment should be taken into consideration for those patients who require an earlier return to daily activities or sport. Level of evidence: Randomized Controlled Clinical Trial, Level 1.",
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AU - Usuelli, Federico Giuseppe

AU - Grassi, Miriam

AU - Maccario, Camilla

AU - Vigano’, Marco

AU - Lanfranchi, Luciano

AU - Alfieri Montrasio, Umberto

AU - de Girolamo, Laura

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