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Macroscopic, histological, histomorphometric, immunohistochemical and blood and synovial fluid analyses were evaluated at 2 and 4\u00a0months from the treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Samples obtained by the three procedures yielded 85\u201395% of viable cells. In vivo assessments showed no significant side effects or inflammatory responses after the injection. The macroscopic Hanashi score did not show significant differences among treated groups and controls. The histopathological evaluation of synovial tissues showed lower signs of synovitis for MF, although the semiquantitative analysis (Krenn score) did not reach statistical significance. Instead, MF showed the best results both in terms of qualitative and semi\u2010quantitative evaluations of articular cartilage, with a more uniform staining, a smoother surface and a significantly better Laverty score (<jats:italic>p<\/jats:italic>\u2009=\u20090.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MF, SVF, and expanded ADSCs did not elicit significant local or systemic adverse reactions in this preclinical OA model. Among the different methods used to exploit the adipose tissue potential, MF showed the most promising findings in particular in terms of protection of the articular surface from the joint degenerative OA processes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Preclinical animal study.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06373-y","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T01:03:05Z","timestamp":1611018185000},"page":"773-781","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Micro\u2010fragmentation is a valid alternative to cell expansion and enzymatic digestion of adipose tissue for the treatment of knee osteoarthritis: a comparative preclinical study"],"prefix":"10.1002","volume":"30","author":[{"given":"Giuseppe","family":"Filardo","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Applied and 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