ACP SVF is the most advanced cellular regenerative therapy in our offering. SVF (Stromal Vascular Fraction) contains a rich population of mesenchymal stem cells derived from the patient’s own adipose tissue, which stimulate the natural regeneration of cartilage, tendons and other joint structures.

What is SVF and What Does it Contain?

Adipose tissue is not only an energy reserve – it is also the richest source of adult stem cells in the body. The stromal vascular fraction (SVF) isolated from adipose tissue contains a heterogeneous population of cells with enormous regenerative potential:

  • ADSCs – mesenchymal stem/stromal cells from adipose tissue (Adipose-Derived Stem/Stromal Cells), capable of differentiating into chondrocytes (cartilage cells), tenocytes (tendon cells) and osteoblasts (bone cells)
  • Endothelial cells and endothelial precursors (EC, EPC) – stimulate angiogenesis (formation of new blood vessels)
  • Pericytes – cells regulating microcirculation function
  • M2 macrophages (anti-inflammatory) – modulate the inflammatory response towards healing
  • Regulatory T lymphocytes (Treg) – suppress immune autoaggression in the joint
  • Extracellular matrix containing natural growth factors

Mechanism of Action – How Do Cells Regenerate the Joint?

Current research indicates that the therapeutic effect of SVF is primarily paracrine – the cells do not so much ‘become’ chondrocytes as they produce a ‘cocktail’ of bioactive proteins modulating the joint microenvironment:

  • Inhibition of the inflammatory cascade (reduction of IL-1β, TNF-α, MMPs)
  • Stimulation of proliferation of resident stem chondrocytes in the deep cartilage layer
  • Induction of angiogenesis in periarticular soft tissues
  • Polarisation of macrophages towards the repair M2 phenotype
  • Stimulation of type II collagen and proteoglycan synthesis (key cartilage components)

The result is a slowing of degenerative disease progression, pain reduction, improved joint function and – in some patients – partial cartilage structure restoration visible on MRI.

Arthrex ACA Technology – What Sets it Apart?

The ACA (Autologous Conditioned Adipose Tissue) technique by Arthrex is a modern method of mechanical SVF extraction, without the use of collagenase (an enzyme) or other foreign substances. This is a key advantage from a safety and regulatory compliance perspective (EU and FDA guidelines on minimal manipulation):

  • Collection of autologous adipose tissue from the abdomen or thigh by liposuction under local anaesthesia (typically 30–60 ml)
  • Single centrifugation cycle → production of microfat with uniform 1.2 mm particle size – with intact adipocytes preserved (volumetric effect + matrix)
  • Mechanical disruption of adipocytes → isolation of SVF as an injection-ready cell pellet
  • Fully closed sterile process performed in the procedure room (point-of-care) in approximately 120 minutes
  • No collagenase → preparation consistent with ‘minimal manipulation’ definition, no risk of immune reaction to a foreign enzyme
  • Option to combine SVF with PRP/ACP – synergy of stem cells and platelet-derived growth factors

Indications for ACP SVF

  • Advanced knee joint degenerative disease (Grade II–III Kellgren-Lawrence) – patients not yet qualifying for arthroplasty or deferring surgery
  • Hip joint degenerative disease
  • Degenerative disease and changes in the shoulder joint (rotator cuff arthropathy)
  • Articular cartilage injuries (focal chondral defects)
  • Difficult-to-heal tendinopathies and tendon injuries after PRP failure
  • Patients who have received previous corticosteroid injections with diminishing efficacy

Step-by-Step Procedure

  • Qualifying consultation with MRI/X-ray assessment and therapy strategy planning.
  • On the day of the procedure the patient is admitted for approximately 2–3 hours. Under local anaesthesia, mini-liposuction is performed: 30–60 ml of adipose tissue is collected from the abdomen or thigh through 2–3 mm incisions.
  • The adipose tissue undergoes the Arthrex ACA process in a sterile, closed system – centrifugation, mechanical disruption of adipocytes, SVF isolation.
  • The resulting SVF concentrate (optionally enriched with PRP/ACP) is administered into the joint under ultrasound or X-ray guidance.
  • Post-procedure observation for 30–60 minutes, then discharge home with a third-party driver.

Effects

  • First effects: 4–8 weeks after the procedure (reduction in morning stiffness, pain reduction)
  • Full effect: 3–6 months – visible improvement in range of motion, sleep quality and reduced medication use
  • Duration of effect: 12–24 months, in selected studies up to 4 years
  • Possible stabilisation or slowing of degenerative changes visible on follow-up MRI
  • In patients with very advanced changes SVF will not replace arthroplasty, but may significantly delay the need for surgery

FAQ

Is SVF the same as stem cell therapy?

SVF contains mesenchymal stem cells (ADSCs) as one of many populations, but is not a ‘pure’ stem cell preparation. It also contains endothelial cells, pericytes, M2 macrophages and others – which paradoxically increases efficacy due to synergistic action. Unlike cell culture (ASC), SVF is minimally processed and administered directly after isolation.

Will SVF replace my joint replacement?

In patients with advanced gonarthrosis or coxarthrosis, SVF will not fully rebuild destroyed cartilage, but can significantly reduce symptoms and delay the need for surgery. In younger patients with moderate changes, the effect may be long-lasting.

Why combine SVF with PRP?

Combining SVF + PRP/ACP creates synergy: stem cells from adipose tissue provide regenerative potential, while platelets supply the ‘fuel’ – growth factors (PDGF, TGF-β1, VEGF, EGF) that activate SVF cells and stimulate their activity.