Fat Tissue Treatment Outperforms Standard Surgery for Hip Cartilage Damage

Study Compares Two Arthroscopic Approaches Over Two Years

This research followed 35 patients with a specific type of hip cartilage problem called acetabular delamination. This condition happens when the cartilage lining the hip socket separates from the underlying bone. It commonly occurs alongside femoroacetabular impingement (FAI), where abnormal bone shapes cause the hip bones to rub against each other.

Researchers compared two surgical treatments. Eighteen patients received microfractures, a standard technique that creates tiny holes in bone to stimulate healing. Seventeen patients received micro-fragmented adipose tissue transplantation using Lipogems® technology. Both groups had similar characteristics, including average age (mid-thirties) and cartilage damage size (one to two square centimeters).

Fat Tissue Procedure Uses Your Own Healing Cells

The Lipogems® treatment involves a straightforward process performed during the same surgery that addresses the underlying hip impingement. Surgeons harvest about 40 milliliters of fat tissue from near the hip through gentle liposuction. This tissue is then processed using a closed system that breaks it into tiny fragments while preserving its natural healing properties.

The processed tissue—about seven milliliters—contains mesenchymal stem cells (regenerative cells that can develop into various tissue types). Surgeons inject this material directly into the hip joint to cover the damaged cartilage area. The entire procedure happens in one surgical session without adding significant time or complexity.

MATT Patients Achieved Near-Perfect Hip Function Scores

The results strongly favored the fat tissue treatment. Researchers measured outcomes using the modified Harris Hip Score, a well-established tool that rates hip function from zero to one hundred. Higher scores indicate better function with less pain.

• Before surgery: Both groups started similarly—50 points for microfractures and 53 points for MATT

• After two years: The microfracture group improved to 76 points, while the MATT group reached 97 points

This 21-point difference between the two groups was statistically significant. A score of 97 represents near-normal hip function. The MATT group's improvement of 44 points nearly doubled the microfracture group's 26-point gain.

Neither Group Required Hip Replacement During Follow-Up

An encouraging finding was that no patient in either group needed a total hip replacement during the two-year study period. No one required revision surgery either. This suggests both treatments provided meaningful relief, though the fat tissue approach delivered substantially better functional outcomes.

All surgeries were performed by the same experienced surgeon using arthroscopic (keyhole) techniques. Patients received treatment for their underlying impingement during the same procedure, including reshaping of abnormal bone and repair of damaged labrum (the cartilage ring around the hip socket).

What This Means for Your Treatment Decision

This study provides valuable evidence for patients with hip cartilage damage related to femoroacetabular impingement. The findings suggest that adding Lipogems® micro-fragmented fat tissue during arthroscopic hip surgery may produce better functional results than microfractures alone.

Several factors make this research relevant to your situation:

• Similar patient profile: Participants had cartilage lesions between one and two square centimeters—a common defect size

• Practical approach: The fat tissue harvest adds minimal complexity since it comes from near the surgical site

• Single procedure: No second surgery or lengthy preparation is required

• Meaningful follow-up: Two years provides reasonable insight into durability

However, this was a relatively small study with 35 total patients. It was also retrospective, meaning researchers looked back at existing cases rather than randomly assigning treatments. Larger studies with longer follow-up would strengthen these findings.

If you have hip cartilage damage from femoroacetabular impingement, discuss these results with your orthopedic surgeon. They can help determine whether the MATT approach might be appropriate based on your specific cartilage damage, overall hip health, and treatment goals.

Source: Ivone et al., Acta Biomedica, 2020.