Three-Year Study Shows Lasting Benefits for Knee Osteoarthritis
A. Russo, D. Screpis, S. L. Di Donato, S. Bonetti, G. Piovan, C. Zorzi · 2018
Fat Tissue Injections Maintain Pain Relief Over Three Years
Researchers tracked 30 patients who received micro-fragmented adipose tissue (MFAT) [specially processed fat from the patient's own body] for knee cartilage damage. After three years, 22 patients who didn't need additional treatments showed their improvements held steady. The benefits seen at one year weren't lost—they were maintained through the three-year mark.
Over Half of Patients Report Major Pain Reduction
Pain relief was significant for most participants. Fifty-five percent of patients improved their pain scores by at least 30 points on a standard pain scale. This level of improvement represents a meaningful change in daily comfort and quality of life. The patients started with various degrees of cartilage damage, including severe cases.
No Safety Concerns Reported in Three-Year Period
The study found no serious side effects during the entire observation period. Researchers specifically looked for:
Lipodystrophy (abnormal fat distribution) at the harvest site
Unusual inflammatory reactions in the knee joint
Any other adverse events
None of these complications occurred in any of the 29 patients who completed the study.
Most Patients Continued Improving After First Year
Remarkably, many patients didn't just maintain their one-year results—they got even better. Between year one and year three:
64% showed continued improvement in overall knee function scores
55% reported better pain levels
55% improved on the International Knee Documentation Committee scale
41% showed gains in knee function testing
Study Included Patients With Severe Cartilage Damage
This wasn't a study of mild cases. Forty-one percent of participants had the most severe grade of cartilage damage. The study included patients with damage in multiple knee compartments. Nine patients (41%) had three-compartment involvement, meaning damage throughout the knee. Most patients (82%) also had other procedures performed alongside the MFAT injection, such as ligament reconstruction or osteotomy [bone realignment surgery].
Seven Patients Needed Additional Treatments
To provide a complete picture: seven patients (23%) required additional treatments between 18 and 30 months after their procedure. Six received platelet-rich plasma injections, and one had hyaluronic acid injections. Importantly, even these patients didn't get worse compared to their condition before the original procedure.
The researchers concluded that micro-fragmented adipose tissue injection is a simple, affordable, and minimally invasive option for managing degenerative knee cartilage damage. The three-year results suggest this approach offers meaningful benefits that last, without the complications sometimes seen with more invasive procedures.
Source: Russo et al., None, 2018.
Original Publication
Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis: an update at 3 year follow-up
A. Russo, D. Screpis, S. L. Di Donato, S. Bonetti, G. Piovan, C. Zorzi · 2018
Autologous micro-fragmented adipose tissue was evaluated as an adjuvant treatment for diffuse degenerative knee chondral lesions at 3-year follow-up in 30 patients initially treated between January and December 2014. The adipose tissue was obtained using minimal manipulation technique in a closed system, capitalizing on the anti-inflammatory and regenerative properties of mesenchymal stem cells within the stromal vascular fraction. Of the original cohort, 24 patients (80%) underwent associated surgical procedures while six (20%) had arthroscopy alone. At 3-year follow-up, one patient was lost and seven (23%) required additional treatments and were considered failures. The remaining 22 patients who received no additional interventions maintained clinical improvements observed at 1-year follow-up. Additionally, 41-64% of patients showed further improvement compared to 1-year outcomes across multiple assessment scales (Tegner Lysholm Knee, VAS, IKDC-subjective, and KOOS). More than 50% of patients improved at least 20 points across all scores compared to pre-operative values. No adverse events, lipodystrophy at harvest sites, or atypical inflammatory joint reactions were reported during the 3-year period. Results demonstrate that autologous micro-fragmented adipose tissue injection represents a safe, simple, minimally invasive, and affordable approach for managing diffuse degenerative knee osteoarthritis in the mid-term.