The Effect of Intra-articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis.

Damir Hudetz,Dragan Primorac,Igor Borić,Željko Jeleč,Irena Trbojević-Akmačić,Gordan Lauc,Andrej Radić,Ozren Polašek,Mihovil Plečko,Andrea Skelin,Eduard Rod,Trpimir Vrdoljak

doi:10.3390/genes8100270

Abstract

Osteoarthritis (OA) is one of the leading musculoskeletal disorders in the adult population. It is associated with cartilage damage triggered by the deterioration of the extracellular matrix tissue. The present study explores the effect of intra-articular injection of autologous microfragmented adipose tissue to host chondrocytes and cartilage proteoglycans in patients with knee OA. A prospective, non-randomized, interventional, single-center, open-label clinical trial was conducted from January 2016 to April 2017. A total of 17 patients were enrolled in the study, and 32 knees with osteoarthritis were assessed. Surgical intervention (lipoaspiration) followed by tissue processing and intra-articular injection of the final microfragmented adipose tissue product into the affected knee(s) was performed in all patients. Patients were assessed for visual analogue scale (VAS), delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and immunoglobulin G (IgG) glycans at the baseline, three, six and 12 months after the treatment. Magnetic resonance sequence in dGEMRIC due to infiltration of the anionic, negatively charged contrast gadopentetate dimeglumine (Gd-DTPA2−) into the cartilage indicated that the contents of cartilage glycosaminoglycans significantly increased in specific areas of the treated knee joint. In addition, dGEMRIC consequently reflected subsequent changes in the mechanical axis of the lower extremities. The results of our study indicate that the use of autologous and microfragmented adipose tissue in patients with knee OA (measured by dGEMRIC MRI) increased glycosaminoglycan (GAG) content in hyaline cartilage, which is in line with observed VAS and clinical results.

Highlights

Articular cartilage is a tissue serving solely mechanical purposes
All the patients enrolled in the study showed similar baseline characteristic of age, height, weight, body mass index (BMI) and radiographic Kellgren Lawrence grade of osteoarthritis (3 or 4)
Our study has shown intra-articular articular autologous and micro‐fragmented adipose tissue injection in patients with autologous and micro-fragmented adipose tissue injection in patients with knee osteoarthritisknee was osteoarthritis with any adverse events including chondrotoxicity

Summary

Introduction

Articular cartilage is a tissue serving solely mechanical purposes It enables movement of the joints by absorbing and resisting mechanical loads, while enabling low friction between adjacent joint surfaces at the same time. Knee osteoarthritis treatments are a severe burden for society in terms of cost, and there is not much scientific evidence to support available treatment options aside from total knee arthroplasty, in terms of efficacy in preventing further development of the disease. Options such as knee arthroscopy with debridement, corticosteroid injection, and platelet rich plasma (PRP) injection have a limited therapeutic reach [4]

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Results

Conclusion