微碎脂肪组织治疗伴骨关节炎半月板撕裂患者的临床评估：一项前瞻性初步研究。
Clinical evaluation of micro-fragmented adipose tissue as a treatment option for patients with meniscus tears with osteoarthritis: a prospective pilot study.
机构信息
New Jersey Regenerative Institute LLC, 197 Ridgedale Ave Suite 210, Cedar Knolls, NJ, 07927, USA.
Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
出版信息
Int Orthop. 2021 Feb;45(2):473-480. doi: 10.1007/s00264-020-04835-z. Epub 2020 Oct 7.
PURPOSE
The management of knee pain secondary to meniscal tears with osteoarthritis is limited by the poor inherent healing potential of the meniscus. Previous studies have reported on the benefit of autologous micro-fragmented fat as a therapeutic for various knee pathologies. The goal of this prospective pilot study was to determine the safety and potential treatment effect of micro-fragmented adipose tissue injection for patients with knee pain secondary to osteoarthritis and meniscal tears who have failed conservative management.
METHODS
Twenty subjects with knee pain secondary to osteoarthritis with associated meniscal tear after failed conservative management were enrolled in the study. Numeric Pain Scale (NPS) and Knee Injury and Osteoarthritis Outcome Scale (KOOS) following ultrasound-guided intra-meniscal and intra-articular micro-fragmented adipose tissue injections were examined at three, six and 12 months.
RESULTS
The mean NPS revealed a significant decrease in patient pain at the 1-year time point compared with baseline (5.45 to 2.21, p < .001). Similarly, overall, mean KOOS symptoms significantly improved from 57.7 to 78.2 (p < .001), with all 4 KOOS subscales demonstrating significant improvement at the final one year follow-up. One subject developed uncomplicated cellulitis at the harvest site which was treated with oral antibiotics. Other complications were minor and mostly limited to adipose harvest.
CONCLUSION
This study demonstrated that micro-fragmented adipose tissue injected directly into a torn meniscus and knee joint using ultrasound guidance represents a safe and potentially efficacious treatment option for patients with knee pain suffering from degenerative arthritis and degenerative meniscal tears. A larger, randomized, controlled trial is warranted to determine efficacy.
TRIAL REGISTRATION
Clinicaltrials.org Identifier: NCT03714659.
目的
膝关节半月板撕裂伴骨关节炎引起的膝关节疼痛的治疗方法受到半月板固有愈合潜力差的限制。先前的研究报告了自体微粉碎脂肪作为治疗各种膝关节病变的益处。本前瞻性试点研究的目的是确定微粉碎脂肪组织注射治疗膝关节疼痛伴骨关节炎和半月板撕裂的患者的安全性和潜在疗效，这些患者经保守治疗失败。
方法
本研究纳入了 20 名因保守治疗失败而患有膝关节疼痛伴骨关节炎相关半月板撕裂的患者。在超声引导下对半月板内和关节内微粉碎脂肪组织注射后，使用数字疼痛量表（NPS）和膝关节损伤和骨关节炎结果评分（KOOS）进行评估，分别在 3、6 和 12 个月进行评估。
结果
平均 NPS 显示，与基线相比，患者疼痛在 1 年时显著降低（5.45 降至 2.21，p <.001）。同样，总体而言，KOOS 症状评分从 57.7 显著提高至 78.2（p <.001），所有 4 个 KOOS 亚量表在最后 1 年随访时均显著改善。1 例患者在脂肪采集部位出现单纯性蜂窝织炎，用口服抗生素治疗。其他并发症较轻，主要局限于脂肪采集。
结论
本研究表明，在超声引导下将微粉碎脂肪组织直接注射到撕裂的半月板和膝关节中，是一种安全且潜在有效的治疗方法，适用于患有退行性关节炎和退行性半月板撕裂的膝关节疼痛患者。需要更大规模、随机、对照试验来确定疗效。
试验注册
Clinicaltrials.org 标识符：NCT03714659。
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