Skip to main content
Top
Published in: International Orthopaedics 3/2021

01-03-2021 | Osteoarthrosis | Original Paper

Treatment of knee osteoarthritis by intra-articular injection of concentrated autologous adipose tissue: a twenty four month follow-up study

Authors: Alessandro Bistolfi, Ilaria Roato, Giulia Fornelli, Luigi Sabatini, Alessandro Massè, Riccardo Ferracini

Published in: International Orthopaedics | Issue 3/2021

Login to get access

Abstract

Purpose

To evaluate the safety and efficacy of autologous concentrated adipose tissue for the treatment of knee OA.

Methods

Eighty-seven patients with knee arthritis from grade 1 to 3, according to Kellgren-Lawrence scale, have been treated with knee arthroscopy and successive intra-articular injection of concentrated adipose tissue. The efficacy of the treatment has been evaluated by the Knee Society Score, Lysholm Score, Forgotten Joint Score, Knee Injury and Osteoarthritis Outcome Score and Noise Reporting Scale.

Results

A total of 78/87 patients concluded the study. Overall, the patients were satisfied with the intervention and a significant reduction of the pain was observed in 67 patients, while the others did not report any change in pain severity or worsening. A statistically significant improvement was observed in the considered orthopaedic index, and no major adverse effects were described. The first week after the intervention, most patients reported knee swelling. Five patients failed because they underwent knee replacement surgery between five and nine months from treatment.

Conclusions

In patients with knee OA, a single intra-articular injection of autologous adipose tissue reduced knee pain, stiffness, improved knee function and quality of life without severe complications.
Appendix
Available only for authorised users
Literature
2.
go back to reference Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, Doherty M, Geenen R, Hammond A, Kjeken I, Lohmander LS, Lund H, Mallen CD, Nava T, Oliver S, Pavelka K, Pitsillidou I, da Silva JA, de la Torre J, Zanoli G, Vliet Vlieland TP (2013) EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 72(7):1125–1135. https://doi.org/10.1136/annrheumdis-2012-202745CrossRefPubMed Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, Doherty M, Geenen R, Hammond A, Kjeken I, Lohmander LS, Lund H, Mallen CD, Nava T, Oliver S, Pavelka K, Pitsillidou I, da Silva JA, de la Torre J, Zanoli G, Vliet Vlieland TP (2013) EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis 72(7):1125–1135. https://​doi.​org/​10.​1136/​annrheumdis-2012-202745CrossRefPubMed
9.
go back to reference Roato I, Belisario DC, Compagno M, Lena A, Bistolfi A, Maccari L, Mussano F, Genova T, Godio L, Perale G, Formica M, Cambieri I, Castagnoli C, Robba T, Felli L, Ferracini R (2019) Concentrated adipose tissue infusion for the treatment of knee osteoarthritis: clinical and histological observations. Int Orthop 43(1):15–23. https://doi.org/10.1007/s00264-018-4192-4CrossRefPubMed Roato I, Belisario DC, Compagno M, Lena A, Bistolfi A, Maccari L, Mussano F, Genova T, Godio L, Perale G, Formica M, Cambieri I, Castagnoli C, Robba T, Felli L, Ferracini R (2019) Concentrated adipose tissue infusion for the treatment of knee osteoarthritis: clinical and histological observations. Int Orthop 43(1):15–23. https://​doi.​org/​10.​1007/​s00264-018-4192-4CrossRefPubMed
10.
go back to reference Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C (2013) A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 22(11):2063–2077. https://doi.org/10.3727/096368912X657855CrossRefPubMed Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C (2013) A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 22(11):2063–2077. https://​doi.​org/​10.​3727/​096368912X657855​CrossRefPubMed
11.
go back to reference Roato I, Mussano F, Reano S, Boriani F, Margara A, Ferracini R, Adriani E, Sabry O, Fiorini M, Fattori P (2020) A novel method to optimize autologous adipose tissue recovery with extracellular matrix preservation. Processes 2020, 8(1), 58; https://doi.org/10.3390/pr8010058 Roato I, Mussano F, Reano S, Boriani F, Margara A, Ferracini R, Adriani E, Sabry O, Fiorini M, Fattori P (2020) A novel method to optimize autologous adipose tissue recovery with extracellular matrix preservation. Processes 2020, 8(1), 58; https://​doi.​org/​10.​3390/​pr8010058
14.
go back to reference Borić I, Hudetz D, Rod E, Jelec Z, Vrdoljak T, Skelin A, Polasek O, Plecko M, Trbojevic-Akmacic I, Lauc G, Primorac D (2019) A 24-month follow-up study of the effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis. Genes (Basel) 10(12):1051. https://doi.org/10.3390/genes10121051CrossRef Borić I, Hudetz D, Rod E, Jelec Z, Vrdoljak T, Skelin A, Polasek O, Plecko M, Trbojevic-Akmacic I, Lauc G, Primorac D (2019) A 24-month follow-up study of the effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis. Genes (Basel) 10(12):1051. https://​doi.​org/​10.​3390/​genes10121051CrossRef
15.
go back to reference Russo A, Screpis D, Di Donato SL, Bonetti S, Piovan G, Zorzi C. (2018) Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis: an update at 3 year follow-up. J Exp Orthop. 5(1):52. Published 2018 Dec 19. https://doi.org/10.1186/s40634-018-0169-x Russo A, Screpis D, Di Donato SL, Bonetti S, Piovan G, Zorzi C. (2018) Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis: an update at 3 year follow-up. J Exp Orthop. 5(1):52. Published 2018 Dec 19. https://​doi.​org/​10.​1186/​s40634-018-0169-x
19.
go back to reference Michalek J, Moster R, Lukac L, Proefrock K, Petrasovic M, Rybar J, Capkova M, Chaloupka A, Darinskas A, Michalek J Sr, Kristek J, Travnik J, Jabandziev P, Cibulka M, Holek M, Jurik M, Skopalik J, Kristkova Z, Dudasova Z (2015) Autologous adipose tissue-derived stromal vascular fraction cells application in patients with osteoarthritis. Cell Transplant. https://doi.org/10.3727/096368915X686760 Michalek J, Moster R, Lukac L, Proefrock K, Petrasovic M, Rybar J, Capkova M, Chaloupka A, Darinskas A, Michalek J Sr, Kristek J, Travnik J, Jabandziev P, Cibulka M, Holek M, Jurik M, Skopalik J, Kristkova Z, Dudasova Z (2015) Autologous adipose tissue-derived stromal vascular fraction cells application in patients with osteoarthritis. Cell Transplant. https://​doi.​org/​10.​3727/​096368915X686760​
22.
go back to reference C. Tremolada, V. Colombo, C. Ventura. (2016) Adipose tissue and mesenchymal stem cells: state of the art and Lipogems technology development. Curr Stem Cell Rep. 2(3):304–312 C. Tremolada, V. Colombo, C. Ventura. (2016) Adipose tissue and mesenchymal stem cells: state of the art and Lipogems technology development. Curr Stem Cell Rep. 2(3):304–312
25.
go back to reference Cattaneo G, De Caro A, Napoli F, Chiapale D, Trada P, Camera A. (2018) Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis. BMC Musculoskelet Disord. 30;19(1):176. https://doi.org/10.1186/s12891-018-2105-8 Cattaneo G, De Caro A, Napoli F, Chiapale D, Trada P, Camera A. (2018) Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis. BMC Musculoskelet Disord. 30;19(1):176. https://​doi.​org/​10.​1186/​s12891-018-2105-8
29.
go back to reference Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS (2014) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells 32(5):1254–1266. https://doi.org/10.1002/stem.1634CrossRefPubMed Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS (2014) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells 32(5):1254–1266. https://​doi.​org/​10.​1002/​stem.​1634CrossRefPubMed
Metadata
Title
Treatment of knee osteoarthritis by intra-articular injection of concentrated autologous adipose tissue: a twenty four month follow-up study
Authors
Alessandro Bistolfi
Ilaria Roato
Giulia Fornelli
Luigi Sabatini
Alessandro Massè
Riccardo Ferracini
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 3/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04923-0

Other articles of this Issue 3/2021

International Orthopaedics 3/2021 Go to the issue