In this case cohort preliminary study out of Croatia, the researchers found that MFAT (Microfragmented Adipose Tissue), also known as Fat Stem Cells, showed excellent clinical outcomes in patients with Grade 3 or 4 knee osteoarthritis who would have required Total Knee Replacement (TKR). Of the 20 patients evaluated over 12 months, 3 of them moved onto TKR, but the other 17 (85%) did well and were able to avoid knee replacement surgery.
Of particular note, on the WOMAC scoring systems, meniscal tears of both medial and lateral compartments showed good outcomes.
More striking still was that on BOTH WOMAC and KOOS scoring systems (both HIGHLY validated knee OA scoring systems) the MRI finding of bone marrow edema of the patellofemoral joint (bone marrow in the patella and/or trochlea) predicted a particularly good outcome. At BRO, this gives us confidence in recommending MFAT in more advanced cases of patellofemoral arthritis.
Aim To analyze clinical and functional effects of intra-articular injection of autologous micro-fragmented lipoaspirate (MLA) in patients with late stage knee osteoarthritis (KOA). Secondary aims included classifying cell types contributing to the treatment effect, performing detailed MRI-based classification of KOA, and elucidating the predictors for functional outcomes.
Methods This prospective, non-randomized study was conducted from June 2016 to February 2018 and enrolled 20 patients with late stage symptomatic KOA (Kellgren Lawrence grade III, n = 4; and IV, n = 16) who received an intra-articular injection of autologous MLA in the index knee joint. At baseline radiological KOA grade and MRI were assessed in order to classify the morphology of KOA changes. Stromal vascular fraction cells obtained from MLA samples were stained with antibodies specific for cell surface markers. Patients were evaluated at baseline and 12-months after treatment with visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS).
Results Three patients (15%) received a total knee replacement and were not followed up completely. Seventeen patients (85%) showed a substantial pattern of KOOS and WOMAC improvement, significant in all accounts. KOOS score improved from 46 to 176% when compared with baseline, WOMAC decreased from 40 to 45%, while VAS rating decreased from 54% to 82% (all P values were <0.001). MLA contained endothelial progenitor cells, pericytes, and supra-adventitial adipose stromal cells as most abundant cell phenotypes.
Conclusion This study is among the first to show a positive effect of MLA on patients with late stages KOA.
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