60% of osteoarthritis sufferers see improvement

60% of osteoarthritis sufferers see improvement: First of a kind study evidences effectiveness of MFAT on pain and improved joint function 2 years after treatment.

In a significant discovery for the management of osteoarthritis, a team of surgeons led by experts in London has found that 60% hip osteoarthritis patients experienced an improvement in pain over a 2-year period as a result of micro-fragmented adipose tissue (MFAT) injections.

The study is the largest of its type to be recorded and measures the effectiveness of micro-fragmented adipose tissue (MFAT) injections, and separately the combination treatment of MFAT with platelet-rich plasma (PRP).

The research is a joint project between experts at The Regenerative Clinic, London, The George Emil Palade University, Romania, Manchester Metropolitan University, Manchester and University of Ferrara, Italy. 147 patients suffering from grade 1–4 hip osteoarthritis took part in the study. Hip osteoarthritis (OA) is a major contributor to reduced quality of life and concomitant disability associated with lost working life months.

The peer reviewed research has been published in The Journal of Clinical Medicine in February 2022 and is available as a downloadable pdf. Key findings are:

• Over 60% patients report an improvement in pain
• This is using both visual analogue score for pain (VAS) and Oxford hip score (OHS)
• It shows that an intra-articular injection of MFAT + PRP suggest a positive role for patients with a lower BMI where there may be difficulty in obtaining sufficient MFAT
• In each of the MFAT and MFAT + PRP groups, only 10 patients went on to have a total hip replacement as they did not respond to the treatment. Of these 20, most had higher grades of osteoarthritis (KL 3 and 4)
• No infections or thromboembolic events were observed
• In this first of its kind clinical study, researchers have shown the efficacy of MFAT and combinational preparation in successful amelioration of hip pain together with improved joint function in patients treated with osteoarthritis
• A larger clinical trial is warranted to determine long-term benefits over 2–5 years, and any gender-related differences in response

Professor Nima Heidari, Consultant Orthopaedic and Trauma Surgeon, said; “In this first of its kind clinical study, we have shown the efficacy of MFAT and combinational preparation in successful amelioration of hip pain together with improved joint function in patients treated with osteoarthritis. Both types of intra-articular injections were equally effective in improving pain scores over 6–12 months. We look forward to a larger clinical trial characterize in detail the effectiveness in patients with different grades of osteoarthritis, to determine long-term benefits over 2–5 years, and any osteoarthritis gender-related differences in response.”

He continues; “This work has provided an insight into the optimal time period for MFAT treatments to be effective. Some participants went on to have hip replacement because the hip had deteriorated too far before MFAT treatment commenced. When hip osteoarthritis is very advanced, and the femoral head loses its natural spherical shape then it is unlikely that these kinds of treatments can provide long term effective pain relief.”

Osteoarthritis (OA) is the most common joint disease, affecting more than 250 million people worldwide and being the fourth leading cause of disability in men. Over 95,000 hip replacements are conducted in the United Kingdom each year, while worldwide the number is over 1 million.

Intra-articular injection of various biological materials has shown promise in alleviating symptoms and potentially slowing down the degenerative process. MFAT treatments may offer alternative treatment pathways for the rejuvenation of osteoarthritic joints, pain reduction, aiding recovery from surgery or trauma, and as an alternative to joint replacement or to delay the need for joint replacement.

Micro-fragmented adipose tissue (MFAT) possesses unique biological properties. The adipose tissue has an innate anti-inflammatory quality and contains the highest concentration of MSCs of any tissue in the body (up to 2% of cells sited in the MFAT tissue are MSC compared to a 0.02% in the bone marrow), being derived from the micro vessel pericytes, these multipotent cells maintain the capacity to differentiate into chondrocytes with adequate stimuli.

Patients

The mean patient age at the time of the treatment for the MFAT group was 60 and for MFAT+ PRP was 60 (Table 1). Both groups had a range in grade of hip OA of between 1–4 (median 3) on the KL scale and ASA 1–3 (median of 2; Table 2)). The mean BMI for the MFAT group was 29 and for the MFAT+ PRP was 27. Patients were not separated into different groups for grade of arthritis for the statistical analysis and power calculations due to the overall small numbers of patients in the study. A significant number of patients had severe grade 4 OA at the time of treatment (61/147).