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Table 5 Device/system characteristics and clinical applications in literature

From: The composition of cell-based therapies obtained from point-of-care devices/systems which mechanically dissociate lipoaspirate: a scoping review of the literature

Device/ System

Company and location

Level of automation

Processing Time (mins)

Mechanical techniques used by device/system

Clinical Applications in PubMed indexed studies

Centrifugation

Filtration

Cutting / Mincing

Sedimentation/ Decantation

Washing

Other (Specify)

Adinizer

BSLrest, Busan, South Korea

Manual

Variable (operator dependent)

  

Y

   

Indication: Fat grafting/ Lipofilling

Treatment  [18]: Cellular product applied at varying depths to different aesthetic units of the face in 24 patients.

Outcome: Visual analog scale (VAS) scores at 2 years were consistently high (Range 6-9) from both patient and surgeon.

Adiprep system (+ Smartprep)

Harvest Technologies Corp. Plymouth, MA, USA

Manual + Automated

4

Y

    

Emulsification

None

Fastem

CORIOS Soc. Coop, Milan, Italy

Automated

10

Y

Y

    

Indication: Fat grafting

Treatment  [24]: Cellular product used to enrich fat grafts before breast augmentation in six patients, comparing their clinical results with patients who underwent grafting with standard lipoaspirate (n=16).

Outcome: Greater gain of thickness of both the central and superior-medial quadrants at 6 months vs control.

Hy- Tissue SVF

Fidia Farmaceutici S.p.A, Padua, Italy

Manual

15

 

Y

 

Y

 

Massage

Indication: Osteoarthritis (Animal in vitro study) [22]

Indication: Achilles tendinopathy

Treatment  [71]: 21 patients with non-insertional achilles tendinopathy (28 tendons) were treated unilaterally or bilaterally with autologous cellular product.

Outcome: Significant improvements in VAS, AOFAS and VISA-A scores at 15 and 30 day follow up intervals vs PRP group.

Lipocube Nano

Lipocube Inc, London, UK

Manual

20-30

 

Y

Y

  

Emulsification

None

Lipocube SVF/ CellDrive

Lipocube Inc, London, UK

Manual + Automated

20-30

Y

Y

Y

   

Indication: Fat grafting

Treatment  [67]: SVF cell-enriched fat grafting in 46 patients for various aesthetic and reconstructive applications.

Outcome: No complications. Results on a 4-point patient satisfaction scale ranged from good to excellent.

Lipogems

Lipogems International S.p.A, Milan, Italy

Semi- automated

3-5

 

Y

 

Y

Y

Shaking, Emulsification

ENT

Indication: Vocal cord palsy

Treatment  [54]: 3 patients had laryngoplasty and injection of autologous cellular product.

Outcome: At 12-month follow-up period, voice improvement was consistent in all patients.

General Surgery

Indication: Intersphincteric anal lipofilling

Treatment  [15]: 3 patients with faecal incontinence had autologous cellular product injected in the intersphincteric anal groove.

Outcome: At 1 month post procedure, each patient had an improved Wexner incontinence score. At 6 months, ano-rectal manometry showed an increase of resting pressure and ultrasound showed increased thickness of the sphincter.

Indication: Repair of a vesicouterine fistula

Treatment  [62]: 1 patient had endoscopic transurethral resection of the fistulous tract and injection of autologous cellular product.

Outcome: 3 months post procedure, patient was asymptomatic. Cystoscopy showed appropriate scar tissue and cystogram revealed complete repair of VUF. At 24 months, there were no recurrences.

Orthopaedic Surgery

Indication: Osteoarthritis

Treatment  [7]: 20 patients with knee OA were injected with autologous cellular product and followed up at various intervals.

Outcome: Improvements in Knee injury and Osteoarthritis Outcome Score (KOOS) were significant at 3-,6- and 12-months follow-up. At one year, there were improvements in KOOS pain= 14 points, symptoms= 7, activities of daily living= 13, sports= 19 and quality of life=15.

Treatment  [76]: 25 patients with shoulder OA were injected with autologous cellular product and followed up at various intervals.

Outcome: At one-year, significant improvement (p<0.001) in Visual Analog Scale and disabilities of the arm.

Treatment  [21]: 6 consecutive patients with hip OA were given single intra-articular injection of autologous cellular product and followed up at 6 months.

Outcome: Harris Hip Score improved from 67.2 (mean pre-operative value) to 84.6 (mean pre- post-operative value)

Treatment  [47]: 17 patients with knee OA treated with ultrasound-guided intra-articular injection of autologous cellular product and followed up for up to 12 months.

Outcome: Knee Society Score improved from average 74 (baseline) to 82 (12 months)

Treatment  [59]: 20 patients with temporomandibular OA treated with autologous cellular product after arthrocentesis vs control group (hyaluronic acid instead). Follow up for up to 6 months.

Outcome: Treatment group had a statistically significant superiority in the success rate compared with the control group (P = .018).

Treatment  [72]: 64 patients with symptomatic mild-severe knee OA treated with autologous cellular product. Follow up for up to 12 months.

Outcome: KOOS, NRS and EQ-5D improved significantly at follow-up compared to baseline (p < 0.05).

Treatment  [57]: 52 patients with early knee OA treated with autologous cellular product after arthroscopic debridement. Follow up for up to 24 months.

Outcome: The IKS function score improved from average 57.2 (pre-operatively) to 83.0 (at the latest follow-up) (p<0.01).

Treatment  [73]: 23 patients with early to moderate patellofemoral OA treated with autologous cellular product. Mean follow-up was 22.1 months.

Outcome: Significant improvements in mean IKS knee and function scores vs baseline (35.6 to 61.9 and 52.0 to 82.3 respectively).

Treatment  [58]: 202 patients with OA (Kellgren-Lawrence I-IV) were injected with autologous cellular product. Mean follow-up was 24.5 months.

Outcome: At 6 months, Total KOOS significantly improved from baseline (p 0.001) and between 6-12 months. At 6 months, VAS was reduced vs baseline (p 0.001), increased at 12 months but remained below baseline.

Indication: Used with High Tibial Osteotomy (HTO) for correction of varus knee OA

Treatment  [36]: 42 patients treated with HTO and simultaneous intra articular injection of cellular product vs 43 patients treated with only HTO.

Outcome: No significant results between both treatment groups in terms of KOOS pain, symptoms, sports, and quality of life. However, a significant improvement (p<0.05) in the activities of daily living.