Stanciu Nicolae, Heidari Nima, Slevin Mark, Ujlaki-Nagi Alexandru-Andrei, Trâmbițaș Cristian, Arbănași Emil-Marian, Russu Octav Marius, Melinte Răzvan Marian, Azamfirei Leonard, Brînzaniuc Klara
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania.
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania.
J Clin Med. 2025 Jun 26;14(13):4549. doi: 10.3390/jcm14134549.
This study aims to assess the clinical efficacy of micro-fragmented adipose tissue (MFAT) therapy over three years in patients with KOA and to determine whether short-term improvements at three months can forecast long-term outcomes. A retrospective, observational study was conducted on 335 patients diagnosed with KOA who received a single MFAT injection. The patients were followed up at 3 months, 6 months, 1 year, 2 years, and 3 years, with assessments using the Visual Analog Scale (VAS), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Statistical analysis was performed to assess the differences in preoperative and postoperative scores (VAS, OKS, WOMAC, KOOS) to evaluate the predictive role of 3-month score changes on long-term clinical outcomes. All measured scores (VAS, OKS, WOMAC, KOOS) showed significant improvement at 3 months, with sustained improvements through 3 years ( < 0.001). Early score changes at 3 months were significantly associated with improved clinical outcomes at 1, 2, and 3 years ( < 0.05). Logistic regression confirmed early post-treatment improvements as independent predictors of long-term benefit, except for the VAS score at 3 years ( = 0.098). A comparative analysis between completers and dropouts showed no baseline differences; however, significant outcome differences emerged at later follow-up points. Due to insufficient data at the 3-year mark among dropouts, statistical comparisons were not possible for that time point. MFAT treatment was associated with consistent symptomatic improvement in patients with KOA, and early clinical response at 3 months served as a reliable predictor of long-term pain and function outcomes. While this study focused on patient-reported symptom relief and not structural regeneration, the results support MFAT as a minimally invasive option for symptom management. Early post-treatment response may serve as a useful tool for clinicians to predict long-term therapeutic success and personalize treatment strategies for KOA patients.
本研究旨在评估微片段脂肪组织（MFAT）疗法对膝骨关节炎（KOA）患者三年的临床疗效，并确定三个月时的短期改善是否能够预测长期疗效。对335例诊断为KOA且接受单次MFAT注射的患者进行了一项回顾性观察研究。在3个月、6个月、1年、2年和3年对患者进行随访，使用视觉模拟量表（VAS）、牛津膝关节评分（OKS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及膝关节损伤和骨关节炎转归评分（KOOS）进行评估。进行统计分析以评估术前和术后评分（VAS、OKS、WOMAC、KOOS）的差异，以评估三个月评分变化对长期临床疗效的预测作用。所有测量评分（VAS、OKS、WOMAC、KOOS）在3个月时均显示出显著改善，并持续改善至3年（<0.001）。3个月时的早期评分变化与1年、2年和3年时改善的临床疗效显著相关（<0.05）。逻辑回归证实，除3年时的VAS评分外（=0.098），治疗后早期改善是长期获益的独立预测因素。完成者与退出者之间的比较分析显示，基线无差异；然而，在后期随访点出现了显著的疗效差异。由于退出者在3年时的数据不足，该时间点无法进行统计比较。MFAT治疗与KOA患者症状持续改善相关，3个月时的早期临床反应是长期疼痛和功能疗效的可靠预测指标。虽然本研究关注的是患者报告的症状缓解而非结构再生，但结果支持MFAT作为症状管理的微创选择。治疗后早期反应可能是临床医生预测长期治疗成功并为KOA患者制定个性化治疗策略的有用工具。
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