In a recent prospective open-label, single center, uncontrolled study by Screpis et al (2022) patients with various degrees of knee osteoarthritis were enrolled and underwent a single microfragmented adipose tissue injection using the Lipogems system. A number of basic science and clinical studies have shown beneficial effects of Lipogems in knee osteoarthritis.
In this study a total of 202 patients were enrolled. The study found that pain and functional scores improved regardless of severity (i.e. Kellgrene Lawrence grade), and most patients (64.5%) reported being satisfied with the procedure. At 12-months following the Lipogems procedure, 45.9% of patients who had used pain medication were able to discontinue their use. Only 3.4% of patient went on to get a total knee replacement during the study period (24-months).
Pain was measured using the visual analog scale. Pain scores after the Lipogems procedure remained lower than baseline until the 2-year mark when pain returned to baseline values. Functional improvements lasted over the 2-years that the data was collection, although patients with more advanced knee OA seemed to start notching the effects wearing off at the 1-year mark.
Take home message: This study suggests that Lipogems microfragemented adipose tissue (MFAT) injection seems to be a safe and effective option for patients with knee osteoarthritis. More studies are needed to establish which stage of the disease and patient characteristics are best-suited for orthobiologic procedures to maximize patient efficacy.
In our clinic, MFAT injections are processed using the Lipogems system using the same protocols used in this study. The Lipogems system is a 501(k) FDA approved commercial system for the closed-loop process of lipoaspirate tissue processing. Many patients are looking for another option to major invasive surgery, and in this study processed adipose tissue was used for knee osteoarthritis. Lipogems has been used in multiple orthopedic conditions and is supported by over 115 independent peer reviewed publications and at least 30 of these publications have evaluated Lipogems for knee osteoarthritis.
In vivo, MFAT was able to act as a stem cell-based natural scaffolding for cartilage defect repair [Xu et al, 2019], and has been chondro-protective in a rabbit model for osteoarthritis [Filardo et al, 2021]. The mechanism of these actions depends on the pericyte content (pre-stem cells) and anti-inflammatory properties of the MFAT, which combined seems to have pro-regenerative properties [Vezzani et al, 2018; Nava et al, 2019].
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