Abstract

Background: Autologous adipose-derived stromal vascular fraction (SVF) is increasingly used for symptomatic knee osteoarthritis (OA), but it remains uncertain whether patient age should influence candidacy. We examined whether age was related to 12-month pain response after intra-articular SVF administration. Methods: This retrospective knee-level analysis included 357 knees from 266 patients with Kellgren-Lawrence grade II-IV OA treated with adipose-derived SVF and followed for at least 12 months. Pain was assessed with the visual analog scale (VAS). Group comparisons and Spearman correlation analyses were used to explore relationships between age, baseline variables, injected cell number, and pain outcomes. Results: VAS scores improved from 6.5 ± 1.2 before treatment to 3.1 ± 1.6 at final assessment (p < 0.01). Age did not show a significant association with baseline pain (p = 0.128), final pain (p = 0.088), or measured baseline factors. Higher body mass index, more severe radiographic OA, and lower SVF cell number were associated with less favorable final pain scores. No serious treatment-related adverse event was identified. Conclusions: SVF injection was followed by significant pain reduction at 12 months. In this cohort, chronological age was not a meaningful determinant of response, whereas metabolic burden, structural OA severity, and delivered cell dose were more relevant clinical factors. These results argue against excluding patients from SVF treatment solely because of age.

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