Ankle Osteoarthritis Pain Drops Significantly After Fat Tissue Injection

Ankle osteoarthritis often strikes younger, active people following injuries. Unlike hip or knee arthritis, it frequently results from trauma like fractures or severe sprains. This study examined whether injecting processed fat tissue from your own body could reduce ankle pain and improve function.

31 Patients Tracked for Two Years After Single Injection

Researchers in Italy followed 31 patients with early to moderate ankle osteoarthritis. All participants had tried other treatments first, including anti-inflammatory medications, physical therapy, and previous injections. Each person received a single injection of five milliliters of micro-fragmented adipose tissue (specially processed fat from their own abdomen) directly into their ankle joint.

The patients ranged from 28 to 71 years old. Doctors evaluated their pain levels and ankle function before treatment, then again at six months, twelve months, and two years afterward.

Pain and Function Scores Improve at All Follow-Up Visits

Compared to their starting point, patients showed meaningful improvement at every check-up. The researchers used three standard measurement tools:

• AOFAS scale: Measures overall ankle function and alignment

• FADI score: Assesses how ankle problems affect daily activities

• VAS pain score: Rates pain intensity on a simple scale

All three scores improved significantly from baseline through the two-year mark. This suggests the treatment helped patients move better and hurt less in their daily lives.

Best Results Appear at Twelve Months, Then Partially Fade

The study revealed an important pattern about timing. Patients experienced their peak improvement at the one-year follow-up. Between twelve and twenty-four months, scores declined somewhat—though they remained better than before treatment.

This gradual fade suggests the benefits may not be permanent. However, even at two years, patients still reported meaningful improvements over their pre-treatment condition. Some patients may benefit from repeat injections, though this study did not explore that option.

No Serious Complications Reported During Study Period

Safety is always a concern with any medical procedure. Throughout the entire two-year follow-up, no severe complications occurred. The treatment involves a small incision in the abdomen to collect fat tissue, which is then processed and injected into the ankle under ultrasound guidance.

Because the procedure uses your own tissue (called autologous treatment), there is no risk of rejection or allergic reaction to donor material.

A Promising Option When Other Treatments Have Failed

This study focused on patients who had already tried standard non-surgical treatments without adequate relief. These included:

• Anti-inflammatory medications

• Physical therapy

• Steroid injections

• Viscosupplementation (gel injections)

• Platelet-rich plasma

For people in this situation who want to avoid or delay major surgery like ankle fusion or replacement, micro-fragmented adipose tissue injection offers another possibility. The procedure is minimally invasive and allows gradual return to normal activities.

What This Means for Your Treatment Decision

This research provides encouraging early evidence, but has limitations. There was no comparison group receiving a placebo or different treatment. The 31-patient sample is relatively small. The authors acknowledge that larger, more rigorous studies are needed to confirm these findings.

If you have early or moderate ankle osteoarthritis and previous treatments have not helped enough, this approach may be worth discussing with your doctor. The two-year data suggests meaningful pain relief and improved function, with the strongest benefits appearing around the one-year mark.

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Source: Natali et al., International Orthopaedics, 2021.