Long term efficacy of Micro-fragmented adipose tissue in the treatment of Knee Osteoarthritis

Purpose
Intra-articular injection of Micro-fragmented adipose tissue (MAT) is a minimally invasive technique that has shown promising results for improving function and reducing pain in patients suffering with arthritis. Current treatments, including joint replacement, carry huge risk and if performed in those under the age of 55 are likely to produce poorer outcomes and require revision surgery. The aim of the study was to evaluate the clinical outcomes of patients with knee osteoarthritis (KOA) at 1-year following MAT treatment.

Materials and methods
Pre-op: patients with KOA were x-rayed to assess severity and scored using VAS and OKS. All patients with measures of VAS >5 and OKS <30 were included in the study (n=84). Procedure: autologous adipose tissue was aspirated from each patient under sedation administered by an anaesthetist, and micro-fragmented using the Lipogems® system. The MAT was then injected, using ultrasound guidance, into the affected joint. Post-op: at 3, 6 and 12 months, patients VAS and OKS measures were re-scored and evaluated.

Results
A significant change was recorded comparing pre- and post-operative outcome measures. VAS scores saw improvement (p<0.001) from a mean value of 6.86±1.48, at 3 (3.71±2.67), 6 (3.67±2.82), and 12 months (3.54±3.12). OKS saw improvement (p<0.001) from a mean value of 21.2±5.66, at 3 (31.3±9.64), 6 (29.7±10.3), and 12 months (30.9±8.16). Positive responses for VAS and OKS were observed for >75% of patients at 3 and 6 months, and >80% for those who have reached the 12-month follow-up.

Conclusion
The study demonstrates a significant improvement 1-year following MAT treatment for patients suffering KOA. Most patients experienced reduced pain and increased functionality. Paired with the minimally invasive approach, MAT looks to be an ideal interim treatment for joint arthritis that can delay the need for arthroplasty, preserving the native joint and delaying replacement. Further studies are required to identify the point at which efficacy may be lost.