Email: info@BSBortho.com
LIPOGEMS® is a cutting edge technology that gently processes and uses your body’s own fat tissue to cushion and support areas of injury or damage as your body heals itself. LIPOGEMS is a FDA-cleared device for processing and same-day injection of adipose tissue. This revolutionary new way of processing fat harvest takes full advantage of the complete healing microenvironment.
The Lipogems are created in a closed-system device that uses only sterile saline solution to wash away the impurities. The gentle process micro-fragments the fat, preserving the natural and beneficial properties of the tissue. The optimal size of the Lipogems tissue allows your physician to accurately inject a specific treatment site with a small gauge needle and minimize pain at the injection site.
This in-office procedure is performed under local anesthesia.
Most commonly injections are for larger joints, such as hips and knees, but we also treat shoulders, ankles, and smaller joints in the hand or feet with these therapies.
Stem cell treatments are also an option for chronic tendon issues that have been resistant to platelet rich plasma (PRP) and other treatments. These are typically done in the rotator cuff, lateral elbow and Achilles tendons. Recent literature has shown benefits on Lipogems healing 75% of partial meniscus tears (Malanga et al, 2021). Currently, we do not treat any neck or spinal conditions with stem cell therapy.
The fat is taken from the stomach, “love handles” or thigh areas using a local anesthetic to numb the area. Roughly 4-8 tablespoons of fat is obtained.
The procedure is performed under local anesthesia and the fat harvesting is typically not painful. The anesthesia is applied on the skin surface for 15 minutes to ensure adequate numbing is achieved making the rest of the procedure virtually painless.
The total length of the treatment is typically about 90 minutes, but most of that time is spent waiting for the anesthesia to take effect and the balance of the time is spent processing the adipose tissue.
Compared to bone marrow, 1g of adipose tissue contains 500 times more pluripotent cells than 1g of bone marrow aspirate (Mizuno, 2009). In laboratory studies, cultured adipose derived stem cells have a greater proliferation rate compared to cells isolated from other sources. Ageing may reduce the availability of bone marrow cells (Berenbaum, 2013).
Using the LIPOGEMS system, any impurities in the fat graft are removed and only the beneficial properties of the tissue remains. The fat graft is then injected under ultrasound guidance allowing the mesenchymal stem cells (in companion with a supporting cast of cells and proteins) to maximize the healing benefits.
There is some limited data suggesting autologous mesenchymal stems cells have an ability to regenerate a portion of the cartilage that may be worn down in the patient’s joint (Koh & Yun-Jin, 2013). Whether or not the cartilage regenerates has little correlation with relief of pain. In cases of more advanced arthritis, we are less likely to see any cartilage regeneration.
We use musculoskeletal ultrasound to identify the injured tendon, ligament or joint and to guide the needle at the injection site.
Most patients only require one procedure. In more severe tendon or ligament injuries and in the case of arthritis, multiple injects can be required.
LIPOGEMS procedures are too new to be covered by insurance. Insurance plans typically cover the initial consultation, follow up appointments and therapy if needed. Our billing department can answer questions regarding specific insurance coverage and treatment cost.
References
Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis
is not osteoarthrosis!). Osteoarthritis Cartilage. 2013 Jan;21(1):16-21.
Koh Y-GC, Yun-Jin. Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy. 2013;29(4):748-755.
Malanga GA, Chirichella PS, Hogaboom NS, Capella T. Clinical evaluation
of micro-fragmented adipose tissue as a treatment option for patients
with meniscus tears with osteoarthritis: a prospective pilot study. Int
Orthop. 2021 Feb;45(2):473-480.
Mizuno H. Adipose-derived stem cells for tissue repair and regeneration: ten years of research and a literature review. J Nippon Med Sch. 2009;76:56–66.
Like all medical procedures, regenerative procedures have a success and failure rate. Not all patients will experience the same results, and results may vary based on an individual’s overall condition, severity of the pathology and recovery time.