Treating Complex Knee Problems with Your Body's Own Fat Tissue

73-year-old regains knee function after 2.5 years

This study follows a patient who had severe knee osteoarthritis along with torn meniscus and ligament damage. He had tried many treatments without success, including cortisone shots, hyaluronic acid injections, platelet-rich plasma, and even arthroscopic surgery. His only remaining option was a full knee replacement, which he refused. Instead, he received an injection of his own processed fat tissue using the Lipogems® system.

Before treatment, this patient could barely bend his knee. He walked with a stiff, straight leg and needed his wife's help to put on pants. He couldn't wear regular shoes or ride a bike anymore. His quality of life was severely limited by constant knee pain.

MRI showed severe damage including bone-on-bone arthritis

The patient's imaging revealed multiple serious problems in his knee. His anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) both showed degenerative tears. Large portions of both the medial and lateral meniscus were missing. He also had bone marrow swelling, a small cyst in his thigh bone, and advanced "bone-on-bone" arthritis in multiple areas of the knee.

This combination of damage represents a challenging case. Traditional treatments often fail when so many structures are affected at once.

Procedure uses ultrasound to guide precise fat placement

The treatment was performed using only local anesthesia. Doctors harvested about 60 cc of fat tissue from the patient's abdomen through tiny incisions. This fat was processed through the Lipogems® device, which breaks it into tiny fragments while keeping the healing cells intact.

Using real-time ultrasound imaging, doctors then injected small amounts of the processed fat into specific damaged areas:

• Three cc into the inner knee compartment

• Three cc into the outer knee compartment

• One cc into each meniscus remnant

• Two cc into the damaged ACL

The entire fat processing takes only 15 to 20 minutes. No enzymes or chemicals are added to the tissue.

Pain and function scores improved significantly

After treatment, the patient showed meaningful improvements in several measures. His pain levels dropped on standardized scales. His scores on the KOOS questionnaire, which measures knee function and quality of life, improved. He also gained better range of motion and increased strength in his thigh muscles.

These improvements were maintained through the 2.5-year follow-up period, suggesting lasting benefits from the single treatment.

No adverse events reported during extended follow-up

Throughout the entire study period, including the procedure itself and the 2.5 years afterward, no complications or side effects were observed. This safety profile is consistent with other research on micro-fragmented fat tissue, which uses the patient's own cells and avoids the risks associated with donor tissue or synthetic materials.

Why fat tissue may help damaged joints heal

Fat tissue contains a high concentration of mesenchymal stem cells (MSCs)—about one in every 100 fat cells, compared to just one in 100,000 bone marrow cells. These cells can transform into various tissue types and release healing signals that reduce inflammation and support tissue repair.

The Lipogems® system preserves the natural structure around these cells, called the "niche." Research suggests this intact environment helps the cells work better than when they are extracted using chemical methods. The micro-fragmented fat acts as a natural scaffold that supports healing in damaged joints.

This case represents one patient in an ongoing study. While the results are promising, larger trials with more patients are needed to confirm these findings. However, for patients who have exhausted other options and want to avoid or delay joint replacement surgery, this approach offers a potential alternative worth discussing with a qualified physician.

Source: Striano et al., Open Journal of Regenerative Medicine, 2017.