Fat vs. Bone Marrow Stem Cells for Orthopedics?

Fat vs. Bone Marrow Stem Cells…  When we first started studies using stem cells in 2005, we looked at two possible sources-fat tissue (adipose) and bone marrow aspirate. After a quick search of the U.S. National Library of Medicine, we learned that there was very little if anything published in human or animal models that showed that fat stem cells would be effective for things like healing cartilage, whereas there were hundreds of publications on bone marrow stem cells healing cartilage. Also at that point there was simply no contest, bone marrow won hands down. When we first began seeing fat stem cells (also known as stromal vascular fraction or SVF) being injected into knee and hip joints we were confused, as we knew the literature was pretty clear. With the proliferation of clinics offering fat stem cells for whatever ails you-from arthritis to ALS to Anti-aging, I wanted to revisit this topic. As an update on what’s currently published, below I have graphed the number of citations listed in the U.S. National Library of Medicine under either both fat stem cells or bone marrow in cartilage repair or research as of yesterday:

It’s not hard to see that under fat stem cells (adipose) there still isn’t much published showing that this is the source you would want to use to help cartilage heal. On the other hand, there’s a massive amount of data showing that bone marrow stem cells would be your first choice. I have blogged on a few of these topics before as well:

• Bone marrow stem cells better than fat stem cells for orthopedic injury-head to head comparisons
• Much fewer complications from a bone marrow aspiration to get stem cells than a liposuction to obtain fat stem cells

The upshot? While we use fat as a structural graft containing stem cells as part of our Regenexx-AD procedure, we also add bone marrow stem cells to that procedure for the above reasons. So if you’re told that fat stem cells are the way to treat your knee, there isn’t much published data supporting that claim, where there is a massive amount of data published that bone marrow stem cells may be your best bet.

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile