Lipogems® for Knee Osteoarthritis: What This Study Reveals
Wouter Van Genechten, Kristien Vuylsteke, Pedro Rojas Martinez, Linus Swinnen, Kristof Sas, Peter Verdonk · Journal of Clinical Medicine · 2021
Nearly two-thirds show improvement within three months
Researchers in Belgium studied 64 patients with mild-to-severe knee osteoarthritis who received Lipogems® treatment. Each patient had a single injection of micro-fragmented adipose tissue (specially processed fat from their own body) into their affected knee. Some patients received treatment in both knees.
The results showed that 64% of patients met the criteria for "treatment responders" at three months. This means their pain and function improved enough to meet internationally recognized standards for meaningful improvement.
About half maintain benefits at one year
At the 12-month mark, 45% of patients continued to show meaningful improvement. Those who responded well to treatment saw their pain scores improve by an average of 28 points on a 100-point scale. This represents a substantial reduction in daily knee pain.
Patients completed several questionnaires measuring:
Pain levels during daily activities
Physical function and mobility
Quality of life indicators
All measurements except activity level showed significant improvement compared to before treatment.
MRI scans help predict who responds best
One of the study's most valuable findings involved bone marrow lesions. These are areas of swelling inside the bone that doctors can see on MRI scans. Patients with numerous bone marrow lesions were less likely to respond well to treatment.
When doctors used MRI findings to select patients more carefully, the response rate increased to 70% at one year. This suggests that pre-treatment imaging can help identify who will benefit most from Lipogems® therapy.
Temporary swelling is common but resolves naturally
The study carefully tracked side effects. About 79% of treated knees experienced an inflammatory reaction after injection. This swelling typically resolved on its own within about two to three weeks without additional treatment.
No serious adverse events were reported. The procedure was performed as an outpatient treatment using only local anesthesia.
Single injection offers alternative to repeated treatments
Unlike cortisone shots, hyaluronic acid, or platelet-rich plasma—which often require multiple injections—this study examined a single Lipogems® treatment. The researchers suggest that for well-selected patients, this approach could serve as a meaningful alternative to therapies requiring repeated visits.
The Lipogems® processing system is FDA cleared. It works by gently breaking down fat tissue into tiny clusters while preserving the natural structure that supports healing cells called pericytes and mesenchymal stem cells.
Key takeaways for patients considering treatment
This study provides several practical insights:
Realistic expectations: About half of patients experience lasting improvement at one year
Better outcomes with screening: MRI evaluation before treatment helps predict success
Minimal procedure: Treatment involves local anesthesia and outpatient care
Temporary effects: Some swelling after injection is normal and temporary
Single treatment: Unlike some alternatives, only one injection was given
The researchers concluded that while the overall response rate was moderate, careful patient selection based on MRI findings can significantly improve outcomes. Patients with fewer bone marrow lesions appear to be better candidates for this regenerative approach.
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Source: Van Genechten et al., Journal of Clinical Medicine, 2021.
Original Publication
Autologous Micro-Fragmented Adipose Tissue (MFAT) to Treat Symptomatic Knee Osteoarthritis: Early Outcomes of a Consecutive Case Series
Wouter Van Genechten, Kristien Vuylsteke, Pedro Rojas Martinez, Linus Swinnen, Kristof Sas, Peter Verdonk · Journal of Clinical Medicine · 2021
The study aimed to evaluate the short-term clinical effect, therapeutic response rate (TRR%), and therapy safety of a single intra-articular autologous MFAT injection for symptomatic knee OA. Secondly, patient- and pathology-related parameters were investigated to tighten patient selection for MFAT therapy. Sixty-four subjects with symptomatic mild-severe knee OA were enrolled in a single-center trial and received a unilateral (n = 37) or bilateral (n = 27) MFAT injection. After liposuction, the adipose tissue was mechanically processed with the Lipogems® device, which eventually produced 8-10 cc of MFAT. Subjects were clinically assessed by means of the KOOS, NRS, UCLA, and EQ5D at baseline and 1, 3, 6, and 12 months after injection. Adverse events were recorded at each follow-up timepoint. The TRR was defined according to the OMERACT-OARSI criteria and baseline MRI was scored following the MOAKS classification. The TRR of the index knee was 64% at 3 months and 45% at 12 months after injection. Therapy responders at 12 months improved with 28.3 ± 11.4 on KOOS pain, while non-responders lost -2.1 ± 11.2 points. All clinical scores, except the UCLA, improved significantly at follow-up compared to baseline (p < 0.05). In the bilateral cohort, no difference in baseline scores or TRR was found between the index knee and contralateral knee (n.s.). An inflammatory reaction was reported in 79% of knees and resolved spontaneously within 16.6 ± 13.5 days after MFAT administration. Numerous bone marrow lesions (BML) were negatively correlated with the TRR at 12 months (p = 0.003). The study demonstrated an early clinical improvement but a mediocre response rate of 45% at 12 months after a single intra-articular injection with autologous MFAT. Assessment of bone marrow lesions on MRI can be helpful to increase the therapeutic responsiveness of MFAT up to 70% at 12 months.