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CC BY-NC-ND 4.0 · Joints 2017; 05(02): 089-092
DOI: 10.1055/s-0037-1603672
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Percutaneous Fat Transfer to Treat Knee Osteoarthritis Symptoms: Preliminary Results

Ezio Adriani
1   Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
,
Mariagrazia Moio
2   Department of Plastic Surgery, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy
,
Berardino Di Paola
1   Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
,
Walter Salustri
1   Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
,
Andrea Alfieri
1   Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
,
Paola Parisi
2   Department of Plastic Surgery, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy
,
Marco Ruggiero
2   Department of Plastic Surgery, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy
,
Zack Borab
2   Department of Plastic Surgery, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy
,
Bruno Carlesimo
2   Department of Plastic Surgery, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
28 July 2017 (online)

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Abstract

Purpose This study aims to evaluate the safety and efficacy of autologous aspirated and purified fat tissue injected percutaneously into the knee joint for the treatment of symptomatic osteoarthritis (OA).

Methods We reviewed 30 patients, who received an autologous percutaneous fat injection for the treatment of knee OA, from January 2012 to March 2015. Mean patients' age was 63.3 ± 5.3 years (range, 50–80 years). Body mass index was 25.1 ± 1.7. Clinical evaluation was based on pain visual analog scale (VAS) and WOMAC score for functional and subjective assessment. We also noted the adverse reactions and the consumption of nonsteroidal anti-inflammatory drugs in the posttreatment period.

Results All patients reported improvements with respect to pain: average VAS was 7.7 ± 1.2 at baseline, 5.2 ± 0.2 at 1-month follow-up, and 4.3 ± 1 at 3-month follow-up. A slight deterioration (5.0 ± 1.1) was evidenced at 1 year. Total WOMAC score was 89.9 ± 1.7 at baseline, 66.3 ± 1 at 1 month, 68.6 ± 1.7 at 3 months, and 73.2 ± 1.8 at 12 months of follow-up.

Conclusion Our preliminary findings suggest that autologous percutaneous fat injections are a valid treatment option for knee OA.

Level of Evidence Level IV, therapeutic case series.

Keywords

fat tissue - knee - osteoarthritis - injections - aspirate
 

  • References

  • 1 Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 1997; 13 (04) 456-460
    CrossrefPubMedGoogle Scholar
  • 2 Buckwalter JA, Mankin HJ. Articular cartilage: degeneration and osteoarthritis, repair, regeneration, and transplantation. Instr Course Lect 1998; 47: 487-504
    PubMedGoogle Scholar
  • 3 Amoako AO, Pujalte GGA. Osteoarthritis in young, active, and athletic individuals. Clin Med Insights Arthritis Musculoskelet Disord 2014; 7: 27-32
    PubMedGoogle Scholar
  • 4 Mazzucco L, Balbo V, Cattana E, Guaschino R, Borzini P. Not every PRP-gel is born equal. Evaluation of growth factor availability for tissues through four PRP-gel preparations: Fibrinet, RegenPRP-Kit, Plateltex and one manual procedure. Vox Sang 2009; 97 (02) 110-118
    CrossrefPubMedGoogle Scholar
  • 5 Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing. Sports Med 2003; 33 (05) 381-394
    CrossrefPubMedGoogle Scholar
  • 6 Staudenmaier R, Froelich K, Birner M. , et al. Optimization of platelet isolation and extraction of autogenous TGF-beta in cartilage tissue engineering. Artif Cells Blood Substit Immobil Biotechnol 2009; 37 (06) 265-272
    CrossrefPubMedGoogle Scholar
  • 7 Paterson KL, Nicholls M, Bennell KL, Bates D. Intra-articular injection of photo-activated platelet-rich plasma in patients with knee osteoarthritis: a double-blind, randomized controlled pilot study. BMC Musculoskelet Disord 2016; 17 (01) 67 . Doi: 10.1186/s12891-016-0920-3
    CrossrefPubMedGoogle Scholar
  • 8 Kavadar G, Demircioglu DT, Celik MY, Emre TY. Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study. J Phys Ther Sci 2015; 27 (12) 3863-3867
    CrossrefPubMedGoogle Scholar
  • 9 Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee osteoarthritis: An FDA- sanctioned, randomized, double-blind, placebo-controlled clinical trial. Am J Sports Med 2016; 44 (04) 884-891
    CrossrefPubMedGoogle Scholar
  • 10 Moraes VY, Lenza M, Tamaoki MJ, Faloppa F, Belloti JC. Platelet-rich therapies for musculoskeletal soft tissue injuries. Cochrane Database Syst Rev 2014; 4 (04) CD010071 . Doi: 10.1002/14651858.CD010071. pub2
    PubMedGoogle Scholar
  • 11 Grambart ST. Sports medicine and platelet-rich plasma: nonsurgical therapy. Clin Podiatr Med Surg 2015; 32 (01) 99-107
    CrossrefPubMedGoogle Scholar
  • 12 Duymus TM, Mutlu S, Dernek B, Komur B, Aydogmus S, Kesiktas FN. Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc 2017; 25 (02) 485-492
    CrossrefPubMedGoogle Scholar
  • 13 DeChellis DM, Cortazzo MH. Regenerative medicine in the field of pain medicine: Prolotherapy, platelet-rich plasma therapy, and stem cell therapy—Theory and evidence. Techniques in Regional Anesthesia and Pain Management 2011; 15 (02) 74-80
    CrossrefPubMedGoogle Scholar
  • 14 Misso ML, Pitt VJ, Jones KM, Barnes HN, Piterman L, Green SE. Quality and consistency of clinical practice guidelines for diagnosis and management of osteoarthritis of the hip and knee: a descriptive overview of published guidelines. Med J Aust 2008; 189 (07) 394-399
    PubMedGoogle Scholar
  • 15 Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A. Arthroscopic validation of radiographic grading scales of osteoarthritis of the tibiofemoral joint. Am J Roentgenol 2006; 187 (03) 794-799
    CrossrefPubMedGoogle Scholar
  • 16 Nelson AE, Renner JB, Schwartz TA, Kraus VB, Helmick CG, Jordan JM. Differences in multijoint radiographic osteoarthritis phenotypes among African Americans and Caucasians: the Johnston County Osteoarthritis project. Arthritis Rheum 2011; 63 (12) 3843-3852
    CrossrefPubMedGoogle Scholar
  • 17 Martin JA, Brown T, Heiner A, Buckwalter JA. Post-traumatic osteoarthritis: the role of accelerated chondrocyte senescence. Biorheology 2004; 41 (3-4): 479-491
    PubMedGoogle Scholar
  • 18 Levangie PK, Norkin CC. Joint Structure and Function: A Comprehensive Analysis. 3rd ed. Philadelphia: FA Davis; 2005: 80
    Google Scholar
  • 19 Kon E, Buda R, Filardo G. , et al. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2010; 18 (04) 472-479
    CrossrefPubMedGoogle Scholar
  • 20 Fibel KH, Hillstrom HJ, Halpern BC. State-of-the-art management of knee osteoarthritis. World J Clin Cases 2015; 3 (02) 89-101
    CrossrefPubMedGoogle Scholar
  • 21 Sánchez M, Anitua E, Azofra J, Aguirre JJ, Andia I. Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol 2008; 26 (05) 910-913
    PubMedGoogle Scholar
  • 22 Pak J. Regeneration of human bones in hip osteonecrosis and human cartilage in knee osteoarthritis with autologous adipose-tissue-derived stem cells: a case series. J Med Case Reports 2011; 5: 296-303
    CrossrefPubMedGoogle Scholar
  • 23 Izadpanah R, Trygg C, Patel B. , et al. Biologic properties of mesenchymal stem cells derived from bone marrow and adipose tissue. J Cell Biochem 2006; 99 (05) 1285-1297
    CrossrefPubMedGoogle Scholar
  • 24 Ankrum J, Karp JM. Mesenchymal stem cell therapy: Two steps forward, one step back. Trends Mol Med 2010; 16 (05) 203-209
    CrossrefPubMedGoogle Scholar
  • 25 Tögel F, Weiss K, Yang Y, Hu Z, Zhang P, Westenfelder C. Vasculotropic, paracrine actions of infused mesenchymal stem cells are important to the recovery from acute kidney injury. Am J Physiol Renal Physiol 2007; 292 (05) F1626-F1635
    CrossrefPubMedGoogle Scholar