Patient-Centered Outcomes of Microfragmented Adipose Tissue Treatments of Knee Osteoarthritis: An Observational, Intention-to-Treat Study at Twelve Months
The Regenerative Clinic's view on this research
Mr Nima Heidari: Here at The Regenerative Clinic, we have been treating patients with knee arthritis with micro-fragmented fat for two and a half years. We have collected data diligently on all of our patients in order to keep a very close eye on the improvements that they have following our treatment. We have now collated and analysed this data for a group of our patients with knee arthritis. We have looked at the group with moderate-to-severe arthritis where their pain is graded above 50 on the visual analogue scale. The visual analogue scale is such that 0 is no pain at all and 100 represents pain where the patient needs to access emergency care due to this pain. We have found consistently across various patient reported outcome measures that there is an improvement in the majority of patients who are treated this way. 4/5 patients treated see an improvement in their symptoms at one year. Interestingly, we have also noted that there are very few complications and adverse events associated with this treatment. The most common being discomfort at the site where the fat is usually harvested around the abdomen.
Although not all of our patients have had improvements in the symptoms with 1/5 not deriving a great deal of benefit, 4/5 are glad that they have undertaken the treatment and have seen improvements in their pain and function.
Abstract
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) (); median OKS (function) improved from 25 (IQR 11) to 33.5 (IQR 16) (); and median EQ-5D (quality of life) improved from 0.62 (IQR 0.41) to 0.69 (IQR 0.28) (). 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.