Microfragmented Adipose Injections for Knee Osteoarthritis
Gerard A. Malanga, Sean Bemanian · Journal of Clinical Orthopaedics and Trauma · 2019
Fat-Based Treatment May Help Patients Avoid Knee Replacement
Knee osteoarthritis affects millions of people, causing pain and limiting daily activities. When treatments like physical therapy, medications, and standard injections stop working, many patients face knee replacement surgery. However, not everyone is ready for surgery. About 700,000 knee replacements happen each year in the United States. Concerningly, up to 19 percent of patients still have knee pain after surgery.
Regenerative medicine offers a middle option for patients in this "treatment gap." Micro-fragmented adipose tissue (specially processed fat from your own body) contains cells that support healing. These include pericytes (helper cells for blood vessels) and mesenchymal stem cells (regenerative cells that can become cartilage, bone, or muscle).
Fat Tissue Contains More Healing Cells Than Bone Marrow
Research shows that fat tissue is an excellent source of regenerative cells. Compared to bone marrow, fat-derived cells:
Exist in higher numbers per unit of tissue
Multiply more quickly when grown in laboratory settings
Stay healthier and more effective over time
This makes fat tissue an attractive option for regenerative treatments. The cells can be harvested through a minimally invasive procedure and used the same day.
Studies Show Improved Pain Scores and Cartilage Health
Multiple studies have demonstrated benefits from fat-derived cell treatments for knee osteoarthritis. In animal research, labeled stem cells were still present in joint tissue ten weeks after injection. Cartilage became thicker and tissue showed better preservation.
Human studies have been equally promising. One study found that 87.5 percent of elderly patients showed improved or maintained cartilage when examined with a follow-up procedure. Another trial using 100 million fat-derived cells showed decreased pain scores at six months. Cartilage quality improved without serious side effects.
A study of 21 patients showed that after about eight months, all participants had improved pain scores. MRI scans revealed increased cartilage thickness in their knees.
The Lipogems® Device Meets FDA Safety Requirements
The FDA requires that fat-based treatments follow strict rules. The tissue must be:
Autologous (from your own body)
Used the same day it is harvested
Minimally manipulated (not significantly altered)
Used for the same basic function it serves naturally
The Lipogems® device meets these requirements. It gently micro-fragments and washes fat tissue without using enzymes or other chemicals. This preserves the natural structure and healing properties of the tissue. The final product contains pericytes and mesenchymal stem cells ready to support tissue repair.
A Gentle Process Preserves Natural Healing Properties
The Lipogems® procedure involves a small incision to collect fat tissue. The device then processes the fat using only mild mechanical forces. This approach:
Removes oil and blood residue
Creates uniform, micro-fragmented tissue
Protects the delicate cell structure
Maintains the natural healing environment
Because the tissue is only gently processed, the regenerative cells remain healthy and functional. They can then be injected directly into the affected joint.
An Option Worth Discussing With Your Doctor
This review confirms that fat-derived regenerative treatments show promise for knee osteoarthritis. Multiple studies report improved pain, better function, and healthier cartilage. The Lipogems® device offers a way to harvest and process your own fat tissue while meeting FDA guidelines.
If you have knee osteoarthritis and standard treatments have not provided relief, this approach may be worth exploring. Talk with your doctor about whether micro-fragmented adipose tissue treatment could be appropriate for your situation.
---
Source: Malanga et al., Journal of Clinical Orthopaedics and Trauma, 2019.
Original Publication
Microfragmented adipose injections in the treatment of knee osteoarthritis
Gerard A. Malanga, Sean Bemanian · Journal of Clinical Orthopaedics and Trauma · 2019
As the aging population grows, osteoarthritis (OA) has become increasingly common, leading to pain and functional deficits affecting quality of life. When conservative treatments fail, total knee arthroplasty (TKA) is the standard intervention, with approximately 700,000 procedures performed annually in the United States. However, TKA complications persist, with up to 19% of patients experiencing continued pain post-surgery, and revision surgeries projected to increase over 600% between 2005 and 2030. Regenerative medicine treatments, particularly adipose-derived mesenchymal stem cells (ADSCs), have emerged as alternatives for patients in the "osteoarthritis treatment gap" between failed conservative therapy and surgery. ADSCs are multipotent cells capable of self-renewal and differentiation into various tissue types, including cartilage. Compared to bone marrow aspirate concentrate, ADSCs are present in higher numbers per tissue volume, proliferate more rapidly, and demonstrate greater resistance to senescence. Recent studies have demonstrated that microfragmented adipose tissue injections improve pain scores, functional outcomes (WOMAC, Lysholm, VAS), and cartilage quality on MRI in knee OA patients. This treatment approach shows promise as a safe, minimally invasive option for managing knee osteoarthritis, though FDA regulations require autologous, same-day use with minimal manipulation of harvested tissue.