Adipose-derived mechanically processed tissue in orthopedics: A call for a standard classification system

Adipose-derived cellular therapies (AD-CTs) are increasingly used in orthopedics, yet the field lacks a standardized framework for classifying these heterogeneous products. Although prior efforts have standardized platelet-rich plasma and bone marrow-derived mesenchymal stromal cells, AD preparations remain inconsistently defined and poorly characterized. AD-CTs encompass a range of products including enzymatically derived stromal vascular fraction, culture-expanded adipose-derived mesenchymal stromal cells (AD-MSCs), and mechanically processed adipose tissue (AD-MPT),each with distinct regulatory, cellular, and structural profiles. Unlike stromal vascular fraction and AD-MSCs, which can be quantified using conventional assays, the intact extracellular matrix in AD-MPTs complicates objective characterization. This paper introduces the Mechanical Processing (Harvesting) of Adipose Tissue classification system as a novel framework for standardizing the reporting of AD-MPT harvesting and processing techniques that provides a structured approach to nomenclature and reporting. The system aims to enhance study comparability, facilitate research replication, and support the responsible advancement of adipose-based therapies in musculoskeletal medicine.