Evaluating the Efficacy of Adipose-Derived Stromal Vascular Fraction Injection for Early-Stage Knee Osteoarthritis: A Multicenter Study

Background: Knee osteoarthritis (KOA) is a major cause of disability worldwide, and adipose-derived stromal vascular fraction (SVF) has emerged as a potential regenerative treatment to modify disease progression. Objective: This study aimed to assess the effectiveness of autologous adipose-derived stromal vascular fraction (SVF) through intra-articular injection to treat early-stage knee osteoarthritis (KOA). Materials and Methods: This multicenter observational study (2019–2023) included adults aged 18–65 years with radiographically confirmed knee osteoarthritis. Patients were assigned to one of two groups through a retrospective, non-randomized process based on the actual treatment received during their clinical follow-up. Group T received intra-articular adipose-derived stromal vascular fraction (SVF) injections, while Group C received conservative treatment with non-steroidal anti-inflammatory drugs (NSAIDs) only. SVF was obtained from abdominal adipose tissue using a standardized closed-system device and injected intra-articularly. Pain and functional outcomes were assessed using the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and at 1, 3, 6, 9, and 12 months. Results: Sixty-seven patients (41 SVF, 26 controls) were included, with comparable baseline characteristics (all p > 0.05). Preoperative VAS was lower in the SVF group (7.44 ± 1.44 vs. 8.31 ± 1.09; p = 0.029). At 12 months, VAS significantly decreased to 3.77 ± 1.49 in the SVF group, whereas it increased to 8.85 ± 0.67 in controls (p < 0.001). Similarly, baseline WOMAC scores were lower in the SVF group (62.6 ± 21.7 vs. 76.8 ± 8.76; p = 0.004). At 12 months, WOMAC improved to 29.4 ± 15 in the SVF group but worsened to 87.6 ± 3.21 in controls (p < 0.001). Within-group improvements were significant only in the SVF group (p < 0.001). No procedure-related complications were observed. Conclusions: The autologous adipose-derived stromal vascular fraction is an effective treatment option for early-stage KOA patients. However, a prospective, randomized, controlled study is warranted.