You have full access to this open access article. Current conservative treatments for knee OA provide limited benefits, with symptoms relief for a short amount of time.
Regenerative medicine approaches such as the use of microfragmented adipose tissue mFAT showed promising results in terms of durable effects and the possibility to enhance tissue healing and counteract the progression of the pathology. Nevertheless, up to today, the large part of clinical data about mFAT use refers to uncontrolled studies, especially in the surgical setting. The purpose of this study was to evaluate the effectiveness of mFAT applied in association with arthroscopic debridement AD for the treatment of knee OA, in terms of symptoms relief and tissue healing.
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This study is a prospective, randomized controlled clinical trial. Clinical, radiological and serological assessments were performed at 6 months after treatment. Additional clinical evaluation was performed at the end of the study with an average follow-up of Knee osteoarthritis OA is a common condition, and a variety of conservative solutions has been proposed to control the related symptomatology.
Traditional conservative therapies, including but not limited to anti-inflammatory drugs and viscosupplementation, showed short-term benefits for the management of symptoms, but they have no effect on pathology progression or tissue restoration. In this scenario, an increasing attention has been addressed to the development of treatments potentially targeting the degenerative processes underlying the pathology, including mesenchymal stromal cell MSC -based therapy [ 22 , 40 ].
Adipose tissue, in particular, represents an easy accessible source of MSCs and its micro-fragmentation microfat or mFAT allows to quickly harvest a relevant volume of a minimally manipulated tissue composed by clusters containing MSCs [ 38 ]. This procedure empowers tissue regeneration by improving MSCs secretion of cytokines and angiogenic factors [ 7 , 20 , 25 , 32 , 41 ]. Moreover, mFAT contains an inferior amount of leukocytes [ 3 ] and supra-adventitial-adipose stromal cells with respect to raw adipose tissue, along with an enrichment in endothelial progenitors [ 31 ], that have been described to sustain proliferation and differentiation in an interplay with tissue resident cells [ 17 , 19 ].
