Fat Tissue Injection Shows Signs of Cartilage Repair in Knee Arthritis

Study Tracks Cartilage Health Using Advanced MRI Technology

This 2017 study from Croatia examined whether injecting processed fat tissue into arthritic knees could help rebuild cartilage. Researchers followed 17 patients with moderate to severe knee osteoarthritis for 12 months. They used a specialized MRI technique that can measure the building blocks of healthy cartilage. This approach allowed them to see changes happening inside the cartilage itself, not just pain improvement.

Protective Cartilage Molecules Increased After Treatment

The researchers focused on glycosaminoglycans (GAGs), which are essential molecules that give cartilage its cushioning ability. Think of GAGs as tiny sponges inside your cartilage that absorb shock when you walk or climb stairs. In osteoarthritis, these molecules break down, causing cartilage to lose its protective qualities.

Using a special MRI scan called dGEMRIC, the team found that GAG content significantly increased in specific areas of treated knees. This is an encouraging sign because it suggests the cartilage was actually rebuilding its protective structure, not just feeling better temporarily.

Single Injection Delivered Using Patient's Own Fat Tissue

Each patient received one injection of Lipogems® micro-fragmented adipose tissue (specially processed fat from their own body). The procedure involved:

• Collecting fat tissue through a minor liposuction procedure

• Processing the fat to concentrate healing cells while keeping the tissue intact

• Injecting the prepared tissue directly into the affected knee joint

Because the treatment uses your own tissue, there is no risk of rejection. The fat tissue contains pericytes and mesenchymal stem cells that support the body's natural repair processes.

Pain Scores Improved Alongside Cartilage Changes

Patients reported their pain levels using a visual scale at the start of the study and at three, six, and 12 months afterward. The pain improvements matched what the MRI scans showed. When cartilage GAG content increased in a particular area, patients typically reported less pain. This connection between measurable cartilage changes and how patients actually felt strengthens the findings.

Advanced Imaging Reveals What X-rays Cannot

Standard X-rays only show bone and joint spacing. They cannot detect early cartilage damage or repair. The dGEMRIC technique used in this study works differently. It uses a contrast agent that gets absorbed into cartilage based on how much GAG is present. Healthy cartilage with abundant GAGs shows up differently than damaged cartilage with depleted GAGs.

This imaging approach let researchers track cartilage health at a molecular level. It also revealed that improvements in cartilage quality affected the mechanical alignment of patients' legs, potentially reducing abnormal stress on the joint.

What This Means for Patients Considering Treatment

This study provides early evidence that micro-fragmented fat tissue injection may do more than just relieve pain. It suggests the treatment could help cartilage rebuild its protective structure. However, patients should understand several important points:

• This was a small study with 17 patients and 32 treated knees

• There was no control group receiving a placebo injection

• All patients had moderate to severe osteoarthritis (Kellgren-Lawrence stages III and IV)

• Results were tracked for only 12 months

The findings are promising because current osteoarthritis treatments like steroid injections typically provide only temporary relief. They do not address the underlying cartilage breakdown. This study suggests that fat tissue injection may work differently by supporting actual tissue repair.

Larger studies with control groups are needed to confirm these results. But for patients seeking alternatives to joint replacement surgery, this research adds to growing evidence that regenerative approaches using your own tissue may offer meaningful benefits.

Source: Hudetz et al., Genes, 2017.