The Effect of Intra-articular Injection of Autologous Microfragmented Fat Tissue
Application of adipose derived mesenchymal stem cells (Ad-MSCs) in treating osteoarticular and cartilage lesions
Specialty hospital St. Catherine conducts innovative clinical cell-based therapy with autologous adipose derived mesenchymal stem cells (Ad MSC) using Lipogems® technology in treating patients with osteoarthritis and cartilage lesions. The Lipogems® technology, patented in 2010 (PCT/IB2011/052204) is completely closed tool to harvest, wash, process, and reinject human lipoaspirates, excluding cell culturing techniques.
Patients involved in the procedure are accurately diagnosed on the basis of a physical examination, completed general health survey on pain and physical function and X-rays/MRI as well as with delayed gadolinium-enhanced MR imaging (dGEMRIC) of cartilage to assess the presence of glycosaminoglycan and collagen type II cartilage and the initial condition of the joint and cartilage thickness.
The minimal invasive surgical procedure consists of the infiltration step, in which adrenalin, in a saline solution, and very diluted lidocaine are injected to induce vasoconstriction and local anesthesia, facilitating the subsequent lipoaspiration and the aspiration step, in which a standard liposuction technique is performed.
In closed system, lipoaspirate is processed and refined, reducing adipose cluster dimensions to obtain final lipogems product containing derivate of micronized fatty tissue and vascular/stromal architecture with perycites and mesenchymal stem cells, which is than intra-articulary injected into index knee/hip.
The results of the recent work Bosetti et al. (2015) indicates that Lipogems® bioaspirate has a great regenerative potential with possible effects:
a) become a fibrous tissue that provides mechanical support for the load on the damaged cartilage;
b) induce chondrocytes to proliferate and produce the extracellular matrix;
c) provide Ad-MSC cells at the site of injury, which could regenerate the tissue. Ad-MSC has been shown anti-inflammatory and antibacterial properties related to production of antimicrobial peptite LL-37.
Specialty hospital St. Catherine offers the Lipogems® treatment since 2015. Great interest of patients in treatment and high number of procedures, encouraged us to register a clinical study "Application of adipose derived mesenchymal stem cells (Ad-MSC) in treating osteoarticular and cartilage lesions" (Trial ID ISRCTN13337022) at Bio Med Central platform.
Our preliminary results of dGEMRIC MRI analysis show increase content of glycosaminoglycans in hyaline cartilage, indicating a potential healing and regenerative capabilities of adipose derived mesenchymal stromal/stem cells (Ad-MSC).
Additionally, the results of KOOS score (Knee Injury and Osteoarthritis Outcome Score) confirm improved clinical status, while VAS values indicate significant pain reduction.