Abstract
Stem cell therapies have become widely popular in orthopaedic surgery, with a recent
interest in adipose-derived therapeutics. Adipose-derived mesenchymal signaling cells
(ADSCs) and micronized adipose tissue (MAT) are unique therapies derived from different
processing methods. Characterizing the most influential studies in lipoaspirate research
can help clarify controversies in definitions, identify core literature, and further
collective knowledge for educational purposes. The Science Citation Index Expanded
subsection of the Web of Science Core Collection was systematically searched to identify
the top 50 most cited publications (based on citation/year) on orthopaedic ADSCs or
MAT research. Publication and study characteristics were extracted and reported using
descriptive statistics. Level of evidence was assessed for applicable studies, and
Spearman correlations were calculated to assess the relationship between citation
data and level of evidence. The top 50 articles were published between the years 2003
and 2020, with 78% published in the year 2010 or later. The mean number of citations
was 103.1 ± 81.1. The mean citation rate was 12.4 ± 6.0 citations per year. Of the
21 studies for which level of evidence was assessed, the majority were level III (10,
47.6%). The single study design most common among the top 50 cited articles was in
vitro basic science studies (17 studies, 34%). Twenty-nine articles (58%) were classified
as basic science or translational. Application to treat knee osteoarthritis was the
most common focus of studies (14 studies, 28%), followed by in vitro analysis of growth
factor and cell signaling markers (11 studies, 22%). No correlation was found between
rank, citation rate, or year of publication and level of evidence. This study provides
a current landscape on the most cited articles in lipoaspirates in orthopaedic surgery.
With the expansion of ADSCs and MAT in the past two decades, this study provides the
first historical landmark of the literature and a launching point for future research.
Studies should explicitly state their processing methodology and whether their study
investigates ADSCs or MAT to avoid misinformation.
Keywords
adipose derived - mesenchymal stem cells - stromal vascular fraction - micronized
adipose tissue - bibliometric analysis
