Autologous fat transplantation for the treatment of trapeziometacarpal joint osteoarthritis

Abstract

Rhizarthrosis is a progressive and disabling pathology affecting the carpometacarpal joint. It’s very common in elderly patients and typically affects postmenopausal women. The diagnosis of rhizarthrosis is mainly made by using different physical examination tests and by evaluating the type of pain and it’s then confirmed by imaging. Over the last few years increasing attention has been devoted to the assessment of new treatment techniques for rhizarthrosis. In this context intra-articular injection of autologous fat grafting for cartilage regeneration has demonstrated promising results in experimental settings as an alternative to open surgery procedures. The aim of this study was therefore to sum up the evidences available so far on autologous fat grafting as an emerging treatment for patients affected by carpometacarpal rizarthrosis. An electronic literature research was carried out on Pubmed, Google Scholars and Cochrane Library using “fat grafting”, “fat graft”, “adipose”, “fat transfer” and “lipoaspirate” as search terms. Authors believe autologous fat grafting is an interesting technique, that hand surgeon should keep in mind especially in early stages of rhizarthrosis were pain has not been solved with non-surgical treatment.

New Trends in Injection-Based Therapy for Thumb-Base Osteoarthritis: Where Are We and where Are We Going?

“…Furthermore, a better understanding of the mechanism of actions of PRP and mesenchymal-derived stem cell populations and a standardized preparation method are needed to achieve a higher level of evidence in this field. It is possible that in the future both therapies can obtain a place in the management of TBOA, mainly thanks to their properties of promoting healing cartilage defects, stem cell proliferation and preventing chondrocytes and extra-cellular matrix degradation ( Bonetti et al, 2020 ).…”

AMIC for traumatic focal osteochondral defect of the talar shoulder: a 5 years follow-up prospective cohort study

“…Bone marrow aspirate concentrate has shown promising results in clinical and preclinical studies [ 56 – 61 ]. Mesenchymal stem cells have also been employed to augment chondral procedures with promising outcomes [ 62 – 66 ]. The current literature evidences a high ratio of preclinical to clinical studies on this topic, suggesting that we are in a transition phase to human application.…”

Fat Grafting as Regenerative Surgery: A Current Review

“…Recent research suggests that for those with recalcitrant migraine headache, with persistent symptoms after surgical decompression, fat grafting may provide symptomatic relief. 25 Guyuron and Pourtaheri 34 showed that most patients treated with fat grafting experienced a 50 percent or greater decrease in the frequency, intensity, or duration of migraine headaches. It is possible that fat grafting provides further surgical decompression of nerves by breaking up scar and fascia and providing cushioning around peripheral nerves.…”

“…24 Patients who received fat grafting for trapeziometacarpal joint arthritis have reported satisfaction regarding pain reduction, daily life activities, and hand strength. 25 The low invasiveness of the procedure and early recovery of patients who received autologous fat transfer in the early stages of basal joint osteoarthritis of the thumb make this approach feasible as first-line therapy instead of performing classical procedures such as trapeziectomy. 26 Likewise, the injection of ADSCs into osteoarthritic knees has demonstrated statistically significant improvement in patient-reported pain scores.…”