Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 2
Disclosures: Max H. Epstein, MD: Nothing to disclose
Case Description: An 84-year-old male with chronic, sharp, intermittent, 5/10 left knee pain who presented to an outpatient sports medicine clinic. The pain was associated with a sensation of buckling and made worse with walking >15 minutes, running, or going up stairs. On examination, he exhibited medial joint line pain with valgus pressure applied and a positive McMurray’s test in the medial and lateral posterior horn. Radiograph imaging revealed medial compartment osteoarthritis (OA), and MRI showed degenerative medial meniscus pathology. Subsequent diagnostic ultrasound revealed meniscal extrusion with peripheral body tears and suprapatellar recess effusions. Patient then underwent ultrasound-guided Micro-fragmented Adipose Tissue (MFAT) transfer into the medial meniscus and suprapatellar recess.
Setting: Outpatient Sports Medicine Clinic
Patient: Patient is an 84-year-old male with medical history of hypertension, mitral valve prolapse, coronary artery disease, and surgical history of “pinched nerve surgery”. He is an active man who enjoys rowing and biking. However, he has been limited in activities such as skiing and running, and reports pain on activities of daily living.
Assessment/Results: At 1-month post-intervention, patient reported a 90% improvement in knee pain. On ultrasound imaging there was a decrease in meniscal extrusion, reduced suprapatellar recess effusion, and scaffold integration into peripheral meniscal tears compared to pre-injection baseline. 4-month follow up revealed a 90% improvement in mechanical symptoms.
Discussion: MFAT has been reported to improve pain and function in knee osteoarthritis and meniscal pathology in myriad studies. Despite its use in the treatment of knee OA, there has been few imaging studies or reports to suggest MFAT has a role in improvement of knee cartilage, joint space narrowing, or meniscus extrusion.
Conclusion: This case demonstrates improvement in medial joint symptoms, functional progress, as well as knee architecture as seen on dynamic ultrasound, suggesting micro-fragmented adipose tissue as a viable orthobiologic for treating these conditions.
Level of Evidence: Level V
To cite this abstract in AMA style:Epstein MH, Song B, Nguyen DD, Jayaram P. Micro-Fragmented Adipose Tissue Transfer Improves Knee Architecture in Degenerative Joint Disease [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/micro-fragmented-adipose-tissue-transfer-improves-knee-architecture-in-degenerative-joint-disease/. Accessed January 25, 2022.
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