Autologous and micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis

December 13, 2019


Background: Chondral lesions of the knee represent a challenge for the orthopaedic surgeon. Several treatments
have been proposed with variable success rate. Recently, new therapeutic approaches, such as the use of mesenchymal stem cells, have shown promising results. The adipose tissue is a good source of these naturally
occurring regenerative cells, due to its abundance and easy access. In addition, it can be used to provide cushioning and filling of structural defects. The 1-year safety and outcome of a single intra-articular injection of
autologous and micro-fragmented adipose tissue in 30 patients affected by diffuse degenerative chondral lesions was evaluated.

Methods: Micro-fragmented adipose tissue was obtained using a minimal manipulation technique in a closed
system. The safety of the procedure was evaluated by recording type and incidence of any adverse event. The
clinical outcomes were determined using the KOOS, IKDC-subjective, Tegner Lysholm Knee, and VAS pain scales
taken pre-operatively and at 12 months follow-up. A level of at least 10 points of improvement in the scores has
been selected as cut-off representing a clinically significant difference.

Results: No relevant complications nor clinical worsening were recorded. A total median improvement of 20 points has been observed in IKDC-subjective and total KOOS, and a higher percentage of success was found in VAS pain and Tegner Lysholm Knee, where the total median improvement was 24 and 31 points, respectively.

Conclusion: The results of this study show the safety and feasibility of using autologous and micro-fragmented
adipose tissue in patients affected by diffuse degenerative chondral lesions. The technique is safe, minimally
invasive, simple, one-step, with low percentage of complications, and compliant with the regulatory panorama.