Early results of intra-articular micro-fragmented lipoaspirate treatment in patients with late stages knee osteoarthritis: a prospective study

Hudetz, Damir; Borić, Igor; Rod, Eduard; Jeleč, Željko; Kunovac, Barbara; Polašek, Ozren; Vrdoljak, Trpimir; Plečko, Mihovil; Skelin, Andrea; Polančec, Denis; Zenić, Lucija; Primorac, Dragan

doi:10.3325/cmj.2019.60.227

Cited by 62 publications

(93 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The medial femorotibial compartment has been shown to have a generally lower dGEMRIC index compared with the lateral femorotibial compartment of the knee, consistent with previous biochemical studies, as well as possibly reflecting a response to different mechanical stresses, according to the location within the joint [21].…”

Section: Discussionsupporting

confidence: 85%

“…One could speculate that the effect of treatment might be diminished with longer than 24 months' follow-up, and that the changes in dGEMRIC values are detectable prior to the changes in the level of pain. Reduction of the joint effusion, decrease in pain sensation on the VAS scale and increase in range of movement enabled more intensive exercising and rehabilitation [21]. This might have had an impact on improving GAG concentration.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A 24-Month Follow-Up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis

Borić

Hudetz

Rod

et al. 2019

Genes

Self Cite

View full text Add to dashboard Cite

Osteoarthritis (OA) is a widely prevalent disease worldwide, and with an increasingly ageing society, it has become a challenge for the field of regenerative medicine. OA is a disease process involving multiple joint tissues, including those not visible on radiography, and is a complex disease process with multiple phenotypes that require evaluation by a multimodality imaging assessment. The purpose of this study was to evaluate the effect of micro-fragmented fat tissue intra-articular injection 24 months after application in two ways: Indirectly using functional magnetic resonance imaging (MRI) assessment analyzing the glycosaminoglycans (GAG) content in cartilage by means of delayed gadolinium (Gd)-enhanced magnetic resonance imaging of cartilage (dGEMRIC), as well as clinical outcome on observed level of GAG using standard orthopedic physical examination including VAS assessment. In our previous study assessing comprehensive results after 12 months, the dGEMRIC results have drawn attention. The present study explores the long-term effect of intra-articular injection of autologous microfragmented adipose tissue to host chondrocytes and cartilage proteoglycans in patients with knee OA. A prospective, non-randomized, interventional, single-center, open-label clinical trial was conducted from January 2016 to April 2018. A total of 17 patients were enrolled in the study, and 32 knees were assessed in a 12-month follow-up, but only 10 patients of them with 18 knees are included in a 24-month follow-up. The rest of the seven patients dropped out of the study 12 months after follow-up: three patients underwent knee arthroplasty, and the remaining four did not fulfil the basic criteria of 24 months involvement in the study. Surgical intervention (lipoaspiration), followed by tissue processing and intra-articular injection of the final microfragmented adipose tissue product into the affected knee(s), was performed in all patients. Patients were assessed for a visual analog scale (VAS), dGEMRIC at the baseline, three, six, 12 and 24 months after the treatment. A magnetic resonance sequence in dGEMRIC due to infiltration of the anionic, negatively-charged contrast gadopentetate dimeglumine (Gd-DTPA2) into the cartilage indicated that the contents of cartilage glycosaminoglycans significantly increased in specific areas of the treated knee joint. Our results suggest that this method of single intra-articular injection of autologous microfragmented adipose tissue improves GAG content on a significant scale, with over half of the measurements suggesting relevant improvement 24 months after intra-articular injection opposed to the expected GAG decrease over the natural course of the disease.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

A 24-Month Follow-Up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis

Borić

Hudetz

Rod

et al. 2019

Genes

Self Cite

View full text Add to dashboard Cite

show abstract

“…At final follow-up, 96.2% of patients expressed satisfaction and reported good or excellent improvements in function and/or pain. Hudetz et al [26] conducted a study where 20 patients with KOA were treated with a single intra-articular injection of microfragmented fat. He noted that 17 (85%) showed a substantial pattern of KOOS and WOMAC improvement, significant in all accounts.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it is important to identify whether treatment with adipose-derived MSCs, or as in this case, MFAT-containing MSCs (originating from the adipose blood vessels as pericytes, and that are released and primed during the extraction process through sheer stress and microfiltration of the fat) [ 23 , 24 ] would be beneficial in providing an optimal biological environment for healing when used in conjunction with surgery [ 25 ]. Their use for the treatment of knee osteoarthritis (KOA) has produced very encouraging results [ 26 – 28 ]. This case series aims to assess the response of our patient cohort over a one-year period following a routine single ultrasound-guided intra-articular injection of MFAT for all grades of KOA.…”

Section: Introductionmentioning

confidence: 99%

Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months

Heidari¹,

Noorani²,

Slevin

et al. 2020

Stem Cells International

View full text Add to dashboard Cite

Introduction. Microfragmented adipose tissue (MFAT) has been shown to benefit osteoarthritic patients by reducing pain and supporting tissue regeneration through a mesenchymal stem cell (MSC)-related paracrine mechanism. This observational study of 110 knees assessed patient-centered outcomes of pain, functionality, and quality of life, analyzing their variation at twelve months following one ultrasound-guided intra-articular injection of autologous MFAT for the treatment of knee osteoarthritis (KOA). Method. Inclusion criteria were as follows: VAS >50, and the presence of KOA as diagnosed on X-ray and MRI. Exclusion criteria included the following: recent injury (<3 months) of the symptomatic knee, intra-articular steroid injections performed within the last three months, and hyaluronic acid injections prior to this treatment. Changes in VAS, OKS, and EQ-5D were scored at baseline and twelve months following a single intra-articular injection of autologous MFAT. Score variation was analyzed utilizing a nonparametric paired samples Wilcoxon test. The statistical analysis is reproducible with Open Access statistical software R (version 4.0.0 or higher). The study was carried out with full patient consent, in a private practice setting. Results. Median VAS (pain) improved from 70 (IQR 20) to 30 (IQR 58) (p<0.001); median OKS (function) improved from 25 (IQR 11) to 33.5 (IQR 16) (p<0.001); and median EQ-5D (quality of life) improved from 0.62 (IQR 0.41) to 0.69 (IQR 0.28) (p<0.001). No adverse events were reported during the intraoperative, recovery, or postoperative periods. Conclusions. For patients with all grades of knee osteoarthritis who were treated with intra-articular injections of MFAT, statistically significant improvements in pain, function, and quality of life were reported. Although further research is warranted, the results are encouraging and suggest a positive role for intra-articular injection of MFAT as a treatment for knee osteoarthritis.

show abstract

“…As already underlined in our previous review, Lipogems ® is currently used within the clinic in several orthopedic contraindications, where intra-articular injections are used to for the management of knee, hip and shoulder osteoarthritic degeneration (more than 35000 patients over the world). Initiated more than three years ago, these results have now been confirmed in several case series [50,51], and prospective clinical studies with follow up [52,53], and the "regenerative" pathophysiological mechanism of Lipogems ® , when injected into the joint, have now been more carefully elucidated [54,55]. MFAT has also been demonstrated effective also in four patients with osteochondral lesions of the talus [56] who underwent to arthroscopic injection of MFAT of the osteochondral lesion after a first phase of microperforation of the cartilage.…”

Section: Orthopedic Surgerymentioning

confidence: 77%

Untitled

2018

SRDT

View full text Add to dashboard Cite

Early results of intra-articular micro-fragmented lipoaspirate treatment in patients with late stages knee osteoarthritis: a prospective study

Cited by 62 publications

References 36 publications

A 24-Month Follow-Up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis

A 24-Month Follow-Up Study of the Effect of Intra-Articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis

Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months

Untitled

Contact Info

Product

Resources

About