Barfod Kristoffer Weisskirchner, Blønd Lars
Dan Med J. 2019 Oct;66(10).
Osteoarthritis (OA) is the leading cause of disability in elderly people. Several non-invasive solutions have been proposed with varying success rates. Recently, new therapeutic approaches, such as the use of minimally manipulated tissue products, have gained increasing popularity. The purpose of this study was to investigate the safety and feasibility of a single intra-articular injection of autologous, microfragmented adipose tissue in patients with knee OA.
The study was performed as a prospective cohort study. Microfragmented adipose tissue was obtained using a minimal manipulation technique (Lipogems). The safety of the procedure was evaluated by recording the type and incidence of any adverse events at three months. The clinical outcomes were determined using the Knee injury and Osteoarthritis Outcome Score (KOOS) scale at three, six and 12 months of follow-up.
Twenty patients were included in the study and all participated in the follow-up. Only one adverse event was registered; a patient complaint of cosmetic changes to the abdominal subcutaneous tissue. The improvements in KOOS were significant at all follow-up. At one year, KOOS pain had improved by 14 points, symptoms by seven, activity of daily living by 13, sports by 19 and quality of life by 15.
The intra-articular injection of autologous, microfragmented adipose tissue for treatment of knee OA seems safe. Randomised controlled trials are needed to elucidate the efficacy of the treatment.
This study was registered in ClinicalTrials.gov (NCT02697682).
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骨关节炎(OA)是老年人残疾的主要原因。已经提出了几种非侵入性解决方案,成功率各不相同。最近,新的治疗方法,如使用微创组织产品,越来越受欢迎。本研究的目的是调查单次关节内注射自体微片段化脂肪组织治疗膝骨关节炎患者的安全性和可行性。
本研究作为一项前瞻性队列研究进行。使用微创技术(Lipogems)获取微片段化脂肪组织。通过记录三个月时任何不良事件的类型和发生率来评估该手术的安全性。在随访的三个月、六个月和十二个月时,使用膝关节损伤和骨关节炎疗效评分(KOOS)量表确定临床结果。
20名患者纳入本研究,所有患者均参与随访。仅记录到1例不良事件;一名患者抱怨腹部皮下组织外观改变。在所有随访中,KOOS评分均有显著改善。一年时,KOOS疼痛评分提高了14分,症状评分提高了7分,日常生活活动评分提高了13分,运动评分提高了19分,生活质量评分提高了15分。
关节内注射自体微片段化脂肪组织治疗膝骨关节炎似乎是安全的。需要进行随机对照试验以阐明该治疗方法的疗效。
本研究已在ClinicalTrials.gov(NCT02697682)注册。
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