Fat Tissue Injection Supports Cartilage Health for Two Years

Study Tracks Cartilage Building Blocks Using Advanced MRI

This Croatian study followed patients with knee osteoarthritis for 24 months after receiving a single injection of their own processed fat tissue (Lipogems®). Researchers used a specialized MRI technique called dGEMRIC to measure glycosaminoglycans (GAGs)—essential molecules that keep cartilage healthy and cushioned. GAGs normally decrease as osteoarthritis progresses, so tracking them reveals whether treatment is helping preserve or rebuild cartilage.

The study enrolled 17 patients with moderate to severe knee osteoarthritis. Ten patients (18 knees total) completed the full two-year follow-up. Three patients left the study because they needed knee replacement surgery. The remaining four did not complete all required visits.

Over Half of Cartilage Measurements Showed Improvement

The results were encouraging. More than half of the cartilage measurements showed meaningful increases in GAG content at 24 months. This finding is particularly significant because GAG levels typically decline over time in people with osteoarthritis. Instead of the expected worsening, many patients showed improved cartilage health.

The dGEMRIC technique works by tracking how contrast dye moves through cartilage. Healthy cartilage with abundant GAGs repels the dye, while damaged cartilage absorbs more of it. Higher readings indicate healthier cartilage with better cushioning ability.

Single Injection Provided Long-Lasting Benefits

Patients received just one injection of micro-fragmented adipose tissue (MFAT)—specially processed fat from their own body. The fat was collected through a minimally invasive lipoaspiration procedure, then processed and injected into the affected knee. No repeat treatments were needed during the study period.

Researchers measured outcomes at baseline, three months, six months, 12 months, and 24 months. Pain levels were tracked using the Visual Analog Scale (VAS), a standard tool where patients rate their pain from zero to ten.

Treatment May Stimulate Cartilage Repair Processes

The study builds on the researchers' earlier 12-month findings, which first suggested that MFAT injection could positively affect cartilage composition. This extended follow-up confirms that benefits can persist for at least two years.

The micro-fragmented fat tissue contains:

• Pericytes: Helper cells that support healing around blood vessels

• Mesenchymal stem cells (MSCs): Regenerative cells that may help repair damaged tissue

• Natural growth factors: Proteins that encourage tissue healing

Because the treatment uses your own tissue (called autologous), there is no risk of rejection or disease transmission from donors.

What This Means for Your Treatment Decision

This study provides objective evidence that MFAT injection can positively influence cartilage health in osteoarthritic knees. Unlike treatments that only mask symptoms, this approach appears to support actual cartilage repair processes at the molecular level.

Key points to consider:

• The specialized MRI technique detected real changes in cartilage composition

• Benefits lasted throughout the two-year study period

• A single injection was sufficient for the observed improvements

• Three of 17 patients still required knee replacement, indicating the treatment may not work for everyone

The study involved patients with advanced osteoarthritis (Kellgren-Lawrence grades III and IV), suggesting that even those with significant joint damage may benefit. However, the small number of patients who completed the full follow-up (10 of 17) means larger studies would strengthen these findings.

If you are considering Lipogems® for knee osteoarthritis, this research suggests the treatment may do more than reduce pain—it may help protect and improve your remaining cartilage. Discuss with your doctor whether your osteoarthritis stage and overall health make you a good candidate for this regenerative approach.

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Source: Borić et al., Genes, 2019.