Gold Jodi Schoenhaus
*Foot, Ankle & Leg Vein Surgery, JRSG Consulting LLC, 670 Glades Rd, Ste 320, Boca Raton, FL 33341.
J Am Podiatr Med Assoc. 2023 May-Jun;113(3). doi: 10.7547/21-216.
Fat pad atrophy is the loss of subcutaneous tissue in the plantar foot, inhibiting the cushioning function. Patients experience severe pain on ambulation from high-pressure forces. Soft-tissue augmentation, or fat pad restoration, is performed to improve the thickness and cushioning ability of the subcutaneous layer. The first of its kind, allograft adipose matrix (AAM), which has been reported to support native fat pad restoration, was evaluated to address fat pad atrophy and the cushioning ability in the plantar foot.
An institutional review board-approved retrospective study review and analysis of 16 patients (21 feet) treated with AAM in the plantar foot was conducted. Adverse events and a subjective patient evaluation of percentage improvement were reported, sometimes supported by imaging.
The mean ± SD volume of AAM injected was 2.2 ± 0.7 mL (range, 1.5-2.6 mL), with a follow-up time of 3 to 20 months, in patients with a mean ± SD age of 68.6 ± 8.9 years. Overall minimal adverse events were observed, and the mean ± SD percentage improvement, as per patient feedback, was 72.9% ± 23.0% (100% corresponds to fully satisfied). The quality of skin improved with reduced presence of callus, and patients resumed their daily activities.
An AAM can support endogenous fat pad restoration by supplementing fat thickness and its natural cushioning ability. The early clinical observations in this retrospective study review demonstrated that patients could resume daily activities after treatment.
脂肪垫萎缩是足底皮下组织的丧失,会抑制缓冲功能。患者因高压力量在行走时会经历严重疼痛。进行软组织增强或脂肪垫修复,以改善皮下层的厚度和缓冲能力。同类首个被报道可支持天然脂肪垫修复的同种异体脂肪基质(AAM),被评估用于解决足底脂肪垫萎缩和缓冲能力问题。
对16例(21足)接受足底AAM治疗的患者进行了一项经机构审查委员会批准的回顾性研究,审查并分析了相关情况。报告了不良事件以及患者对改善百分比的主观评估,有时有影像学支持。
注射的AAM平均体积±标准差为2.2±0.7 mL(范围为1.5 - 2.6 mL),随访时间为3至20个月,患者平均年龄±标准差为68.6±8.9岁。总体观察到的不良事件极少,根据患者反馈,平均改善百分比±标准差为72.9%±23.0%(100%表示完全满意)。皮肤质量有所改善,胼胝出现减少,患者恢复了日常活动。
AAM可通过补充脂肪厚度及其天然缓冲能力来支持内源性脂肪垫修复。这项回顾性研究的早期临床观察表明,患者治疗后可恢复日常活动。