Regenerative orthopedics offers 4 main types of autologous (from the patient's own tissues) concentrates. They differ in source, composition, mechanism of action, and evidence base. We analyze each method objectively.

1. PRP — Platelet-Rich Plasma

Source

Patient's blood (10–60 ml). Centrifugation > platelet concentration 2–5 times.

Mechanism of Action

Platelets contain growth factors (PDGF, TGF-β, VEGF) that stimulate tissue healing. The effect is short-term: factors are released in the first 1–2 hours and degrade within 5–7 days.

Evidence Base

  • Moderate effectiveness in mild osteoarthritis (Kellgren-Lawrence I–II)
  • Tendinopathies — good results (epicondylitis, plantar fasciitis)
  • Herniated discs — insufficient effectiveness (growth factor concentration too low)

Limitations

Does not contain stem cells. Short-term effect. Requires repeat courses (3–5 injections).

2. SVF — Stromal Vascular Fraction

Source

Adipose tissue (50–100 ml, harvested via mini-liposuction). Enzymatic digestion with collagenase > isolation of stem cells.

Mechanism of Action

SVF contains mesenchymal stem cells (MSCs), pericytes, endothelial cells, and growth factors. MSCs can differentiate into chondrocytes and participate in Effect on cartilage tissue.

Evidence Base

  • Knee osteoarthritis — good results in several RCTs
  • Issue: enzymatic processing may damage cells (viability 60–80%)

Regulatory Status

?? In the EU, enzymatic SVF is classified as ATMP (Advanced Therapy Medicinal Product) and requires a special license. Many clinics use it illegally.

3. BMAC — Bone Marrow Aspirate Concentrate

Source

Bone marrow from the iliac crest (30–60 ml, aspiration under anesthesia). Centrifugation > MSC concentration.

Mechanism of Action

BMAC contains MSCs, hematopoietic cells, and growth factors. MSC concentration: 500–2500 cells/ml (significantly lower than in SVF or MFAT).

Evidence Base

  • Good results for nonunions of fractures
  • Moderate for osteoarthritis (lower than SVF due to lower MSC concentration)

Limitations

Painful harvesting procedure. Low MSC concentration. In patients over 50 years, the number of MSCs in bone marrow decreases by 90%.

4. CGF — Concentrated Growth Factors

Source

Patient's blood (20–40 ml). Special centrifugation with variable speed (Medifuge, Silfradent) > fibrin matrix with growth factors.

Mechanism of Action

CGF is the evolution of PRP. Key difference: the fibrin matrix provides prolonged release of growth factors over 7–14 days (vs 1–2 hours for PRP). Concentration of PDGF, TGF-β, VEGF is 5–10 times higher than in standard PRP.

Evidence Base

  • Osteoarthritis — superior to PRP in direct comparisons
  • Disc herniations — effective in combination with stem cells
  • Tendon healing — high efficacy

Comparison Table

ParameterPRPSVFBMACCGF
SourceBloodFat (enzymatic)Bone marrowBlood
Stem cellsNoYes (many)Yes (few)No
Growth factorsLow conc.MediumMediumHigh (5–10? PRP)
Effect duration1–2 hoursWeeksWeeks7–14 days
Harvest invasivenessMinimalMediumHighMinimal
CE MarkYes?? ATMPYesYes
Best forTendinopathyOsteoarthritisFracturesDiscs, joints

Why regenerative treatment Combines CGF + MFAT

The regenerative treatment method uses a combination of the two most effective concentrates:

  • CGF — powerful growth factors with prolonged release
  • MFAT — mechanically processed adipose tissue with live MSCs in native matrix (>95% viability, no enzymes = legal status in EU)

MFAT is not SVF. MFAT technology processes adipose tissue mechanically (without collagenase), preserving the stromal matrix — the microenvironment necessary for cell survival. This is a key advantage over SVF.

Frequently Asked Questions

Which regenerative medicine method is the most effective?
The greatest efficacy is shown by the combined approach, combining CGF, SVF, and BMAC. Each method individually is effective for specific tasks: PRP for tendinitis, SVF for cartilage, BMAC for bone.
What is CGF and how does it differ from PRP?
CGF (Concentrated Growth Factors) is a growth factor concentrate obtained from blood using a special centrifugation protocol. Unlike PRP, CGF contains a fibrin matrix that provides prolonged release of growth factors.
Can PRP and stem cells be combined?
Yes, this combined approach is the basis of regenerative treatment. Growth factors from CGF create a favorable environment, while stem cells from SVF/MFAT provide tissue regeneration.

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