Autologous lipotransfer for bone defects secondary to osteomyelitis: A report of a novel method and systematic review of the literature

Abstract

Autologous bone grafting is the gold standard in patients with bone defects but is associated with significant pain and donor site morbidity. Autologous lipotransfer (fat grafting or lipofilling) has become very popular in the therapy of chronic wounds. Mesenchymal stem cells from adipose tissue are known for their regenerative, reparative, and immunomodulatory effects. This case study and review evaluates the use of autologous lipotransfer for chronic osteomyelitis in a 26‐year‐old patient. A 26‐year‐old female suffering from chronic tibial osteomyelitis was initially treated with surgical debridement and antibiotics followed by lipoharvest and autologous lipofilling. MRI and computed tomography scans were performed at 2 and 6 weeks and 6 months postoperatively. A formal systematic review of clinical trials investigating autologous lipotransfer for osteomyelitis was conducted. The patient remained asymptomatic without recurrence, and the bone defect cavity showed vascularised adipose tissue after 6 weeks, with early signs of osteogenesis. The highest foot and ankle disability index was 100. The systematic review identified 266 studies after duplicates were removed. After screening for eligibility, seven manuscripts were further assessed, with none meeting the inclusion criteria. This is the first study to report the successful use of autologous lipotransfer with early signs of osteogenesis in a patient suffering from chronic osteomyelitis. Autologous lipotransfer is relatively simple, safe, and minimally invasive, making it a potential alternative to current treatments. Further research is required to assess the safety, feasibility, and efficacy of autologous fat grafting and the mechanism of osteogenesis.

Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

“…24 In a recent case study, AFT was suggested as a filler material for bone cavity defects after debridement due to osteomyelitis. 25 Since AFT remains a nonvascularized transplant, defect size plays a dominant role in these considerations. 26,27 Furthermore, a positive effect of AFT on the patient's pain level during the hospital stay was demonstrated.…”

The optimization of pepsin processing time to balance the mechanical and biological properties of xenogeneic bone

“…Over the last decades, the autologous bone transplantation has been the gold standard for treating large bone defects due to its lack of immunogenicity, excellent osteoinductive, and osteogenic properties 3 . However, the limited sources and donor complications limited its wide application 4 . Recently, the metal implants have been widely applied in orthopedic surgeries, especially for arthroplasty and arthroplasty revision surgeries.…”

Differences in the Inflammatory Response of White Adipose Tissue and Adipose-Derived Stem Cells

“…In contrast, the use of simple WAT for clinical purposes is not subject to such strict legal restrictions in most countries, as long as it is used as an unpurified autologous lipo-transfer. Current clinical applications include scar treatment, breast reconstruction after breast cancer surgery, aesthetic rejuvenation, cleft-lip repair and liposculpture for body deformities [30,[33][34][35][36]. The treatment of bone defects, osteomyelitis or chronic wounds is being debated [13,30,[35][36][37][38][39].…”