# Adipose-Derived Stem Cell Therapy Combined With Platelet-Rich Plasma for the Treatment of Avascular Necrosis of the Talus

## TL;DR

A 60-year-old man with talar avascular necrosis showed significant improvement after treatment with a combination of stem cells and platelet-rich plasma.

## Contribution

This case report introduces a novel conservative treatment combining SVF and PRP for non-traumatic talar AVN.

## Key findings

- The patient experienced significant pain relief and returned to non-impact sports after treatment.
- MRI at 18 months showed stable AVN with no collapse, indicating treatment effectiveness.
- Functional scores improved significantly following the combined therapy.

## Abstract

Avascular necrosis (AVN) is characterized by compromised blood supply to bone tissue, often resulting in significant pain and functional impairment. Conservative treatment options for early-stage AVN of the talus are scarce, with non-weight-bearing protocols and hyperbaric oxygen therapy showing limited efficacy. This report presents a potential novel approach to managing non-traumatic AVN of the talus using a combination of adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP). A 60-year-old male presented with progressive right ankle pain of a two-year evolution. Magnetic resonance imaging (MRI) revealed stage II AVN of the talus with extensive bone infarctions occupying almost all of its volume but with no collapse. A single injection of SVF and PRP was performed after diagnostic arthroscopy, followed by a tailored rehabilitation protocol. The patient experienced significant pain relief, with no further need for analgesics, and was able to return to non-impact sports. At the 18-month follow-up, functional scores showed significant improvement, and MRI showed stable AVN with no evidence of collapse. This report highlights SVF and PRP as a potential effective conservative option for non-traumatic talar AVN.