Fat Tissue Injection Shows Promise for Stubborn Shoulder Pain
D.M. Robinson, C. Eng, M. Mitchkash, A.S. Tenforde, J. Borg-Stein · Muscles, Ligaments and Tendons Journal · 2020
Harvard Team Tests Regenerative Treatment on 18 Shoulders
Researchers at Spaulding Rehabilitation Hospital, part of Harvard Medical School, studied whether micro-fragmented adipose tissue (MFAT) could help patients with persistent shoulder problems. They treated 16 patients (18 shoulders total) who had shoulder arthritis or rotator cuff tears. All patients had tried other treatments without success. These failed treatments included physical therapy, steroid injections, and sometimes even surgery.
The study focused on patients who had suffered shoulder pain for at least six months. Each person received a single injection of processed fat tissue from their own body. The researchers then tracked their progress for at least six months.
Pain Scores Drop Significantly After Single Injection
The results showed meaningful improvement in pain levels. Patients reported their pain using a zero-to-ten scale. On average, pain scores dropped significantly by the six-month mark. The improvement was statistically significant, meaning it was unlikely to be due to chance alone.
Beyond just pain reduction, patients also reported better daily function. Researchers measured this using the Pain Disability Index. This questionnaire asks about how pain affects activities like recreation, self-care, and work. These scores also improved significantly at six months.
No Major Side Effects Reported in Any Patient
Safety is always a concern with any medical procedure. In this study, no major complications occurred. This is important because the treatment involves harvesting fat tissue and injecting it into the shoulder joint.
The procedure uses the Lipogems® system to process fat tissue from the patient's own body. Because it uses your own tissue (called autologous treatment), the risk of rejection is very low. The processing method is gentle and mechanical. It does not use enzymes or expand cells in a laboratory.
Treatment Helps Patients Who Failed Other Options
What makes this study particularly interesting is the patient population. Everyone in the study had already tried multiple treatments without adequate relief. Many had received:
Physical therapy
Steroid injections
Lubricant injections (viscosupplementation)
Platelet-rich plasma (PRP) therapy
Some had even undergone prior surgery
For these patients, the next traditional step would typically be major surgery like shoulder replacement. This regenerative approach offers a less invasive alternative worth considering.
Injection Takes Small Amount of Processed Fat Tissue
The procedure itself is minimally invasive. Fat is harvested from the flank or thigh area using local anesthesia. The tissue is then processed using the Lipogems® device to create micro-fragmented fat.
For shoulder arthritis, doctors injected an average of about five milliliters of processed tissue. For rotator cuff problems, they used about one to two milliliters. Experienced physicians performed all injections using ultrasound guidance. This ensures precise placement of the healing tissue.
Study Limitations Worth Noting
This was a case series, which is an early-stage type of research. There was no comparison group receiving a different treatment or placebo. With only 18 shoulders studied, the sample size was small. Larger, controlled studies are needed to confirm these findings.
However, the consistent improvement across patients and the excellent safety profile are encouraging. The researchers note that MFAT "may be helpful to improve pain and function in a subset of patients" with these chronic shoulder conditions.
What This Means for Your Decision
If you have chronic shoulder pain from arthritis or rotator cuff damage, and other treatments have not worked, this study suggests MFAT injection may be worth discussing with your doctor. The treatment appears safe and showed real benefits for patients in similar situations. While more research is needed, these early results from a respected medical institution are promising for people seeking alternatives to major surgery.
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Source: Robinson et al., Muscles, Ligaments and Tendons Journal, 2020.
Original Publication
Outcomes after Micronized Fat Adipose Transfer for Glenohumeral Joint Arthritis and Rotator Cuff Pathology: a Case Series of 18 Shoulders
D.M. Robinson, C. Eng, M. Mitchkash, A.S. Tenforde, J. Borg-Stein · Muscles, Ligaments and Tendons Journal · 2020
This study evaluated the safety and clinical outcomes of micro-fragmented adipose tissue (MFAT) injection for shoulder pain secondary to glenohumeral osteoarthritis and rotator cuff pathology. Sixteen patients (18 shoulders) who had failed previous conservative therapies received a single injection of MFAT using the Lipogems® system. All patients had chronic pain duration greater than 6 months and pathology confirmed by MRI or radiography. The MFAT was harvested from the flank or thigh using tumescent anesthesia, mechanically processed without enzymatic treatment or culture expansion, and injected under ultrasound guidance into the glenohumeral joint or rotator cuff lesions. Outcomes including pain visual analog scale scores and pain disability index scores were assessed at minimum six months follow-up. Results demonstrated significant improvements in visual analog scale scores (p < 0.001) and pain disability index scores (p = 0.02) with no major adverse events observed. The findings suggest that MFAT may be a safe and effective treatment option to improve pain and function in patients with chronic glenohumeral osteoarthritis and rotator cuff tears who have failed conservative management. No major complications were identified in this case series.