Fat Tissue Injection Improves Quality of Life for Patients Facing Knee Replacement
Nima Heidari, Tiffanie-Marie Borg, Stefano Olgiati, Mark Slevin, Alessandro Danovi, Brady Fish, Adrian Wilson, Ali Noorani · BioMed Research International · 2021
220 patients with advanced knee arthritis treated and followed for two years
Researchers in London studied patients with moderate to severe knee osteoarthritis (Kellgren-Lawrence grades 3 and 4) who received a single injection of Lipogems® micro-fragmented adipose tissue (MFAT). The study included 95 women and 125 men, treating a total of 344 knees. All patients had tried other treatments before choosing MFAT. Researchers tracked their progress for two years using standard questionnaires that measure knee function and overall quality of life.
Patients eligible for knee replacement saw meaningful improvement
The study focused on patients whose symptoms were severe enough to qualify for total knee replacement surgery. Doctors often use the Oxford Knee Score (OKS) to decide who needs surgery. Patients scoring 27 or below typically have a 70% or greater chance of benefiting from knee replacement. In this study, patients in this most-affected group showed statistically significant improvement in quality of life at two years after their MFAT injection. The improvement was strong enough to reach statistical significance (p value less than 0.001).
Quality of life gains confirmed across multiple severity levels
Researchers divided patients into three groups based on their starting knee function scores:
Severely affected (OKS 27 or below): These patients would typically be recommended for knee replacement. They showed significant quality of life improvement.
Moderately affected (OKS 28-39): These patients fall in a gray zone where some might benefit from surgery. They also showed significant improvement.
Mildly affected (OKS above 39): These patients have less severe symptoms and were analyzed separately.
Both the severely and moderately affected groups showed meaningful gains in quality of life as measured by the EQ-5D questionnaire. This tool assesses five areas: mobility, self-care, daily activities, pain, and mood.
MFAT offers a low-risk alternative that may delay surgery
The researchers concluded that MFAT injection can delay the need for total knee replacement in suitable patients. This matters for several important reasons. Knee replacement surgery, while effective, carries risks including infection, blood clots, and a recovery period of several months. Some patients cannot have surgery due to other health conditions. Others may face long waiting lists or limited access to surgical care.
The COVID-19 pandemic highlighted another concern. Elective surgeries were canceled worldwide during the crisis. Having a minimally invasive treatment option available provides patients with an alternative when surgery is delayed or unavailable.
A single injection using your own tissue
The MFAT procedure uses fat tissue harvested from the patient's own body. This tissue is then processed to create micro-fragmented adipose tissue. The processed material is injected directly into the affected knee joint. Because the treatment uses your own cells, there is no risk of rejection or allergic reaction. The procedure is minimally invasive compared to joint replacement surgery.
Patients in this study received just one injection and were followed for two years. They completed questionnaires before treatment and at three months, six months, one year, and two years afterward. This long follow-up period helps confirm that the benefits last over time.
What this means for patients considering treatment options
This study suggests that MFAT injection can provide meaningful, lasting improvement for patients with knee osteoarthritis. Even patients with symptoms severe enough to warrant knee replacement surgery experienced better quality of life after treatment. For those who want to avoid or delay major surgery, MFAT represents a promising option worth discussing with a qualified physician. The treatment may be especially valuable for patients who face barriers to surgery or prefer to try less invasive approaches first.
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Source: Heidari et al., BioMed Research International, 2021.
Original Publication
Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years
Nima Heidari, Tiffanie-Marie Borg, Stefano Olgiati, Mark Slevin, Alessandro Danovi, Brady Fish, Adrian Wilson, Ali Noorani · BioMed Research International · 2021
Knee osteoarthritis (KOA) is a significant cause of disability in a globally ageing population. Knee replacement surgery has been shown to improve function and quality of life, but access can be limited by rationing, lack of healthcare provision, and suspension of elective orthopaedic care. Recent therapies including microfragmented adipose tissue (MFAT) have emerged as alternatives to relieve pain and improve function in KOA patients. This study identified patients with KOA Kellgren-Lawrence grade 3 and 4 treated with a single MFAT injection, applying published Oxford Knee Score (OKS) thresholds for total knee replacement (TKR) referral to separate them into cohorts by functional impairment. 220 patients (95 females, 125 males) with KOA received one MFAT injection. Function (OKS) and quality of life (EuroQol-5) were compared before and 24 months after therapy. MFAT injection provided statistically significant improvement in quality of life (EQ-5D) at 24 months in patients with baseline OKS of 39 or less (p<0.001) and those with OKS of 27 or less deemed suitable for knee replacement (p<0.001). MFAT injection improves quality of life in KOA patients deemed suitable for knee replacement. MFAT is a low-morbidity alternative biological treatment that can delay the need for total knee replacement in suitable patients.