Tendon Regeneration: A New Option for Full-Thickness Tennis Elbow Tears

Complete tendon healing seen without surgery in one patient

For people with severe tennis elbow involving full-thickness tendon tears, surgery has traditionally been the only real option. This case study describes a different path. A 56-year-old man with a complete tear of his common extensor tendon (the tendon group at the outer elbow) was treated with Lipogems® microfragmented adipose tissue instead of surgery. The torn tendon not only healed but showed complete bridging and remodeling on imaging scans.

Steroid injection preceded the tear—fat graft aided repair

The patient had received a corticosteroid injection for elbow pain before his tendon fully tore. Research suggests steroid injections may increase tendon rupture risk over time. After the tear occurred, doctors harvested fat tissue from the patient's flank area. This tissue was processed to create micro-fragmented adipose tissue (MFAT)—specially cleaned fat containing regenerative cells. The MFAT was then injected directly into the tear site using ultrasound guidance for precision.

Imaging confirmed healing at seven and fifteen weeks

The results were documented using both ultrasound and MRI imaging at follow-up visits:

• At seven weeks: Ultrasound showed the torn tendon edges had begun bridging together

• At fifteen weeks: Complete remodeling was visible, and the prior retraction (where the torn tendon had pulled back) had resolved

• Patient-reported outcomes: The man experienced significant improvements in both pain levels and elbow function

This timeline is remarkable. Traditional surgical repair typically requires months of recovery before patients see substantial improvement.

Why fat tissue may help tendons heal

Adipose (fat) tissue is one of the body's richest sources of mesenchymal stem cells and pericytes—regenerative cells that support tissue repair. When processed through the Lipogems® system, these cells are preserved along with their natural supportive structure. The treatment works by supplementing the body's own repair mechanisms rather than replacing tissue.

Tendons naturally have poor blood supply. This makes healing difficult, especially for severe tears. The regenerative cells in MFAT may help by:

• Promoting collagen production (the protein that gives tendons their strength)

• Supporting new blood vessel formation at the injury site

• Providing growth factors that encourage tissue repair

Full-thickness tears typically need surgery—until now

The distinction between partial and full-thickness tears matters greatly for treatment decisions. Partial tears often respond to conservative treatments like rest, physical therapy, bracing, or platelet-rich plasma injections. Full-thickness tears—where the damage extends completely through the tendon—have historically required surgical intervention for meaningful recovery.

This case is significant because it demonstrates that even severe tears may respond to regenerative treatment. For patients who cannot undergo surgery due to health conditions, or who prefer to avoid the risks and recovery time of an operation, MFAT offers a potential alternative.

More research needed to confirm these findings

While these results are promising, this report describes only one patient. The authors emphasize that randomized controlled trials are needed to fully evaluate how well MFAT works for full-thickness tendon tears. Such trials would compare outcomes between patients receiving MFAT and those receiving other treatments, providing stronger evidence about effectiveness.

For now, this case adds to the growing body of research supporting Lipogems® technology for orthopedic conditions. It suggests that regenerative medicine may expand treatment options even for injuries that once demanded surgical repair.

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Source: Siddiqui et al., Regenerative Medicine, 2024.