PMID- 37968496
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240426
IS  - 2197-1153 (Print)
IS  - 2197-1153 (Electronic)
IS  - 2197-1153 (Linking)
VI  - 10
IP  - 1
DP  - 2023 Nov 16
TI  - Autologous micro-fragmented adipose tissue injection provides significant and 
      prolonged clinical improvement in patients with knee osteoarthritis: a 
      case-series study.
PG  - 116
LID - 10.1186/s40634-023-00668-y [doi]
LID - 116
AB  - PURPOSE: Among the conservative strategies to manage patients with symptomatic 
      knee osteoarthritis (OA), an innovative approach exploiting the regenerative 
      capability of adipose tissue and its resident MSCs (Mesenchymal Stem Cells or 
      Medicinal Signalling Cells) has been proposed with encouraging results. This 
      study aims to demonstrate the benefits of autologous micro-fragmented adipose 
      tissue (MAT) injection in the conservative treatment of knee osteoarthritis and 
      whether any variables may affect the outcome. This is a case series single-centre 
      study in which patients underwent intraarticular MAT injection without any 
      associated procedures. METHODS: Based on inclusion and exclusion criteria, 49 
      patients (67 Knees) were included and retrospectively analysed with a mean 
      follow-up of 34.04 +/- 13.62 months (minimum 11 - maximum 59). Patients were 
      assessed through the WOMAC and KOOS questionnaires at baseline (pre-treatment) 
      and 1-, 3-, 6-, 12-, 24- and 36-month follow-up. A minimal clinically important 
      difference (MCID) of at least 7.5 points for the WOMAC pain scale and 7.2 for the 
      WOMAC function scale compared to the baseline value was used. RESULTS: WOMAC and 
      KOOS scores improved after treatment compared to baseline at all follow-ups with 
      p < 0.001. Male gender and Kellgren-Lawrence (KL) grade 2 were associated with 
      smaller improvement in WOMAC and KOOS scores (with respect to females and to KL 
      grade 1, respectively) up to 24 months. The percentage of patients who reach the 
      MCID for WOMAC pain is generally lower than that of patients who reach the MCID 
      for WOMAC function (around 80% at all time points), but it increases 
      significantly over time. Moreover, the baseline score of the WOMAC pain and 
      function influence the outcome. Patients with worse symptoms are more likely to 
      reach the MCID. CONCLUSIONS: Intra-articular knee injection of MAT for the 
      treatment of knee osteoarthritis (KOA), recalcitrant to traditional conservative 
      treatments, proved to be effective in a high percentage of cases. The positive 
      association between a worse pre-operative score and a better clinical response to 
      the treatment would support the idea that intra-articular administration of MAT 
      could be considered in patients with very symptomatic KOA in which 
      joint-replacement surgeries are not indicated (or accepted). LEVEL OF EVIDENCE: 
      IV, case series.
CI  - (c) 2023. The Author(s).
FAU - Russo, Arcangelo
AU  - Russo A
AUID- ORCID: 0000-0003-4120-3333
AD  - Department of Orthopedics, Joint Prosthetic, Arthroscopic Surgery and Sports 
      Traumatology, Humanitas Castelli, Via Mazzini 11, 24128, Bergamo, Italy. 
      arcangelorusso@yahoo.it.
FAU - Cortina, Gabriele
AU  - Cortina G
AD  - Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of 
      Rome, 00128, Rome, Italy.
FAU - Condello, Vincenzo
AU  - Condello V
AD  - Department of Orthopedics, Joint Prosthetic, Arthroscopic Surgery and Sports 
      Traumatology, Humanitas Castelli, Via Mazzini 11, 24128, Bergamo, Italy.
FAU - Collarile, Marco
AU  - Collarile M
AD  - Department of Orthopedics, Joint Prosthetic, Arthroscopic Surgery and Sports 
      Traumatology, Humanitas Castelli, Via Mazzini 11, 24128, Bergamo, Italy.
FAU - Orlandi, Roberto
AU  - Orlandi R
AD  - Department of Orthopedics, Joint Prosthetic, Arthroscopic Surgery and Sports 
      Traumatology, Humanitas Castelli, Via Mazzini 11, 24128, Bergamo, Italy.
FAU - Gianoli, Riccardo
AU  - Gianoli R
AD  - Engineering Department, University of Bergamo, Viale Marconi, 5, 24044, Dalmine, 
      BG, Italy.
FAU - Giuliani, Emanuele
AU  - Giuliani E
AD  - Engineering Department, University of Bergamo, Viale Marconi, 5, 24044, Dalmine, 
      BG, Italy.
FAU - Madonna, Vincenzo
AU  - Madonna V
AD  - Department of Orthopedics, Joint Prosthetic, Arthroscopic Surgery and Sports 
      Traumatology, Humanitas Castelli, Via Mazzini 11, 24128, Bergamo, Italy.
LA  - eng
PT  - Journal Article
DEP - 20231116
PL  - United States
TA  - J Exp Orthop
JT  - Journal of experimental orthopaedics
JID - 101653750
PMC - PMC10651566
OTO - NOTNLM
OT  - Cells (MSCs)
OT  - Knee Osteoarthritis (KOA)
OT  - Mesenchymal Stem Cells or Medicinal Signalling
OT  - Micro-fragmented Adipose Tissue (MAT)
OT  - Minimal Clinical Important Difference (MCID)
COIS- The authors declare no conflict of interest.
EDAT- 2023/11/16 06:44
MHDA- 2023/11/16 06:45
PMCR- 2023/11/16
CRDT- 2023/11/16 00:01
PHST- 2023/02/24 00:00 [received]
PHST- 2023/10/09 00:00 [accepted]
PHST- 2023/11/16 06:45 [medline]
PHST- 2023/11/16 06:44 [pubmed]
PHST- 2023/11/16 00:01 [entrez]
PHST- 2023/11/16 00:00 [pmc-release]
AID - 10.1186/s40634-023-00668-y [pii]
AID - 668 [pii]
AID - 10.1186/s40634-023-00668-y [doi]
PST - epublish
SO  - J Exp Orthop. 2023 Nov 16;10(1):116. doi: 10.1186/s40634-023-00668-y.