自体微碎脂肪组织联合关节镜治疗中重度膝关节骨关节炎：两年随访结果。

Autologous micro-fragmented adipose tissue associated with arthroscopy in moderate-severe knee osteoarthritis: outcome at two year follow-up.

机构信息

Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, Modena, Italy.

出版信息

BMC Musculoskelet Disord. 2022 Nov 8;23(1):963. doi: 10.1186/s12891-022-05921-6.

DOI:10.1186/s12891-022-05921-6

PMID:36348344

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9641752/

Abstract

BACKGROUND

Adipose tissue has recently gained growing interest in the treatment of osteoarthritis (OA). The aim of the present study was to evaluate the efficacy of a single injection of autologous micro-fragmented adipose tissue (aMFAT) associated with arthroscopy (cartilage debridement/meniscal regularization or selective meniscectomy/micro-drilling) for symptomatic knee OA.

METHODS

This retrospective, single-center study included 49 patients (50 knees) affected by knee OA (radiographic Kellgren-Lawrence III-IV) treated with a single injection of autologous micro-fragmented adipose tissue and knee arthroscopy. Knee Injury and Osteoarthritis Outcome Score (KOOS) and subjective International Knee Documentation Committee (IKDC) score were the primary outcome measures and were collected at one and 2 years post-operatively. Patients were divided into clusters based on age, complexity of arthroscopic procedures and chondral lesion grade.

RESULTS

Four patients underwent knee replacement (8%). No major adverse events were reported. Minimal Clinically Important Difference (MCID) for KOOS and IKDC was reached by 84 and 74% of all cases at 1 year and by 80 and 76% at 2 years, respectively. High grade chondral lesions negatively affected the outcome at 2 years follow-up (p < 0.05 for IKDC, KOOS overall and 3 out of 5 subscales).

CONCLUSION

The injection of micro-fragmented adipose tissue associated with arthroscopy demonstrated to be a safe and effective procedure for the treatment of knee OA, with a substantial improvement in IKDC and KOOS scores and without major complications.

摘要

背景

脂肪组织在治疗骨关节炎（OA）方面最近引起了越来越多的关注。本研究旨在评估单次注射自体微碎化脂肪组织（aMFAT）联合关节镜（软骨清创/半月板规整化或选择性半月板切除术/微钻孔）治疗症状性膝骨关节炎的疗效。

方法

这是一项回顾性、单中心研究，共纳入 49 例（50 膝）膝骨关节炎（放射学 Kellgren-Lawrence III-IV 级）患者，均接受单次自体微碎化脂肪组织注射和膝关节镜治疗。膝关节损伤和骨关节炎结果评分（KOOS）和主观国际膝关节文献委员会（IKDC）评分是主要的观察指标，分别在术后 1 年和 2 年进行收集。患者根据年龄、关节镜手术的复杂性和软骨损伤程度进行分组。

结果

4 例患者（8%）接受了膝关节置换术。未报告重大不良事件。KOOS 和 IKDC 的最小临床重要差异（MCID）在术后 1 年达到 84%和 74%，2 年时达到 80%和 76%。高等级软骨损伤对 2 年随访时的结果有负面影响（IKDC、KOOS 总分和 5 个亚量表中的 3 个在 p<0.05 时有统计学意义）。