It probably does not make much difference in terms of clinical results whether an adult stem cell is obtained from bone marrow or from fat. Although some centres claim that bone marrow derived cells are superior to fat derived cells, there is no evidence to substantiate that claim. Recent studies show that fat derived stem cells make bone tissue much better than the bone marrow derived cells. Some studies are showing different outcomes but it is important to realize that these studies are all done in petri dishes in a lab, and may not relate to living humans.
It is also important that one is not misled by marketing materials with the word “bone” in “bone marrow”, implying that this is an “orthopedic source” and therefore it must be optimal for treating orthopedic conditions such as cartilage regeneration. In fact, the bone marrow is part of the reticuloendothelial system (makes blood cells) and just happens to be found in the centre of bone. The truth is, both bone marrow derived and stromal (from fat) derived stem cells are both effective for regenerative therapy and both have the potential to differentiate into mature functional cartilage.
Why do we use fat derived stem cells? Firstly, stem cells from fat are 100 to 1000 times more plentiful than bone marrow stem cells. This makes same day procedures much more effective with fat derived cells. The higher numbers of cells in fat leads to better clinical outcomes. Secondly, it is well documented that the quality and quantity of bone marrow cells declines with advancing age and chronic illness. Thirdly, the ease of obtaining fat from under the skin using a mini cannula harvest procedure under local anesthetic is much less invasive and MUCH LESS painful than undergoing bone marrow aspiration to obtain bone marrow cells.
In addition to quality and ease of obtaining and using adipose derived cells rather than bone marrow derived cells, it is important to consider that there is NO safety data on the intravenous use of bone marrow derived cells. The Cell Surgical Network® (CSN) has safety data (manuscript accepted for publication in American Journal of Cosmetic Surgery March 2017) on 1524 patients with various degenerative, inflammatory, and autoimmune conditions. It is very important for a successful clinic outcome to use intravenous cells (IV deployment) in addition to any joint injections.
Since the stem cells will migrate to wherever they are needed, including soft tissue, other parts of the damaged joint, and even other joints that may be injured, it is our view that an intra-articular injection of stem cells must be supplemented with IV deployment for optimal results. A joint injection alone is insufficient in the CSN network experience of over 6000 patients.