Micro-Fragmented Fat Tissue: A New Approach for Worn Cartilage
Arcangelo Russo, Francesca De Caro, Vincenzo Condello, Marco Collarile, Vincenzo Madonna · Lo Scalpello · 2019
Fat tissue offers millions more regenerative cells than bone marrow
When cartilage wears down in your joints, finding effective treatments can be challenging. This Italian review examines why micro-fragmented adipose tissue (specially processed fat from your own body) has become a promising option for degenerative cartilage conditions.
Researchers found that fat tissue contains far more regenerative cells than bone marrow. From just 300 cc of harvested fat (about one and a quarter cups), doctors can obtain between ten million and 600 million adipose-derived stem cells. Even more encouraging: these cells remain plentiful in fat tissue even after age 70, unlike bone marrow cells that decline significantly with age.
Keeping cells in their natural "home" improves healing potential
One of the most important insights from this review involves how regenerative cells work best. Scientists discovered that stem cells lose much of their healing ability when removed from their natural environment. The solution? Keep the cells within their supportive tissue structure.
Professor Arnold Caplan, a leading researcher, has redefined what these cells do. Rather than simply becoming new tissue, they act as "medicinal signaling cells." This means they help regulate inflammation and coordinate healing processes. They work best when their surrounding cellular network stays intact.
Lipogems® preserves the critical cell network structure
The Lipogems® system processes fat tissue using only mechanical methods. It uses no enzymes, chemicals, or centrifuges. This gentle approach keeps the important perivascular niche (the supportive structure around blood vessels) intact and active.
Studies on Lipogems® tissue show the cells can develop into bone cells, blood vessel cells, and cartilage cells. Pericytes (helper cells that support blood vessel healing) remain highly present and functional. These pericytes serve as precursors to stem cells and help direct the body's response toward repair and regeneration rather than ongoing inflammation.
Simple procedure completed in one surgical session
The treatment follows a straightforward process:
Preparation: The doctor injects a numbing solution into the fat tissue area, typically the abdomen or thigh
Harvesting: After twelve minutes, about 60 cc of fat tissue is collected per joint being treated
Processing: The fat passes through the Lipogems® device, which gently breaks it into smaller pieces while washing away oils and blood
Injection: The processed tissue is then injected into the affected joint
The entire preparation takes only minutes and occurs during a single procedure. The system complies with Italian regulatory requirements and has received approval from the National Transplant Center.
Current treatments for worn cartilage have significant limitations
The review notes that osteoarthritis affects over half the population and causes pain and reduced function. Traditional surgical approaches for widespread cartilage damage have shown disappointing results. Some aggressive cartilage treatments have failed badly, leaving joint replacement as the only remaining option.
This has led doctors to favor less invasive approaches. The guiding principle is "first, do no harm." Injectable treatments using the body's own tissues offer a gentler alternative that preserves future treatment options if needed.
More research needed to confirm true regeneration
The authors acknowledge an important question remains: Can this injection method truly be considered "regenerative"? While biological studies show promising cellular activity, researchers emphasize the need for continued investigation.
For younger patients with cartilage wear but no clear osteoarthritis signs, the goal is reversing the damage trend. For those with more advanced or irreversible joint disease, the treatment may serve as a temporary modulator of joint conditions rather than a permanent fix. Either way, using your own tissue minimizes rejection risks and avoids the complications of donor materials.
---
Source: Russo et al., Lo Scalpello, 2019.
Original Publication
Il trattamento delle condropatie degenerative con tessuto adiposo autologo microframmentato
Arcangelo Russo, Francesca De Caro, Vincenzo Condello, Marco Collarile, Vincenzo Madonna · Lo Scalpello · 2019
Osteoarthritis is a widespread pathology, with a prevalence of over 50% of the population, which leads to pain and functional limitation. At the moment, no surgical technique has been shown to be capable of real regeneration of the chondral layer. The new regenerative frontier seems to be represented by the self-ability of the Stromal Vascular Fraction (SVF) to preserve the cellular network, which is essential for cell regeneration. Several micro-fragmented adipose tissue extraction and processing systems have been refined in the past years and recent literature data show the biological effectiveness of this tissue, which plays a key role in restoring joint homeostasis, through the modulation of inflammation and pain. It will be necessary and important to understand whether this injective method can really be considered a 'regenerative' option.