Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years
Background. Knee osteoarthritis (KOA) is a significant cause of disability in a globally ageing population. Knee replacement surgery has been shown to improve function and quality of life. Access to this intervention can be limited for a number of reasons including rationing of care, lack of healthc...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Stem Cells International |
| Online Access: | http://dx.doi.org/10.1155/2021/9921015 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832563635144097792 |
|---|---|
| author | Nima Heidari Tiffanie-Marie Borg Stefano Olgiati Mark Slevin Alessandro Danovi Brady Fish Adrian Wilson Ali Noorani |
| author_facet | Nima Heidari Tiffanie-Marie Borg Stefano Olgiati Mark Slevin Alessandro Danovi Brady Fish Adrian Wilson Ali Noorani |
| author_sort | Nima Heidari |
| collection | DOAJ |
| description | Background. Knee osteoarthritis (KOA) is a significant cause of disability in a globally ageing population. Knee replacement surgery has been shown to improve function and quality of life. Access to this intervention can be limited for a number of reasons including rationing of care, lack of healthcare provision in austere environments, and more recently, due to the cessation of elective orthopaedic care as a result of the COVID pandemic. Referral for knee replacement surgery is often guided by the patient’s Oxford Knee Score (OKS). Recent therapies including treatment with microfragmented adipose tissue (MFAT) have emerged as alternatives to relieve pain and improve function in such patients. Method. We identified all patients with KOA Kellgren-Lawrence grade 3 and 4 in our dataset of patients treated with a single injection of MFAT and applied published OKS thresholds for referral for TKR to separate them into 3 cohorts according to their functional impairment. 220 patients (95 females, 125 males) with KOA were given one MFAT injection. The function (OKS) and quality of life (EuroQol-5) prior to and 24 months after therapy were compared. Results. MFAT injection provided a statistically significant improvement in the quality of life (EQ-5D) at 24 months in patients with a baseline OKS of 39 or less (p value: <0.001) as well as those with OKS of 27 or less who are deemed suitable for a knee replacement (p value: <0.001). Conclusion. MFAT injection improves quality of life in patients with KOA who are deemed suitable for the knee replacement. MFAT is a low-morbidity alternative biological treatment and can delay the need for total knee replacement in suitable patients. |
| format | Article |
| id | doaj-art-5a0e5eade38842978f19b02460da30aa |
| institution | Kabale University |
| issn | 1687-966X 1687-9678 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stem Cells International |
| spelling | doaj-art-5a0e5eade38842978f19b02460da30aa2025-02-03T01:12:54ZengWileyStem Cells International1687-966X1687-96782021-01-01202110.1155/2021/99210159921015Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two YearsNima Heidari0Tiffanie-Marie Borg1Stefano Olgiati2Mark Slevin3Alessandro Danovi4Brady Fish5Adrian Wilson6Ali Noorani7The Regenerative Clinic, 18-22 Queen Anne Street, London, UKAcademic Plastic and Reconstructive Surgery Group, Barts and the London School of Medicine, London, UKnext AI, London, UKDepartment of Life Sciences, Manchester Metropolitan University, UKDepartment of Quantitative Methods, University of Bergamo, 24129 Bergamo, Italynext AI, London, UKThe Regenerative Clinic, 18-22 Queen Anne Street, London, UKThe Regenerative Clinic, 18-22 Queen Anne Street, London, UKBackground. Knee osteoarthritis (KOA) is a significant cause of disability in a globally ageing population. Knee replacement surgery has been shown to improve function and quality of life. Access to this intervention can be limited for a number of reasons including rationing of care, lack of healthcare provision in austere environments, and more recently, due to the cessation of elective orthopaedic care as a result of the COVID pandemic. Referral for knee replacement surgery is often guided by the patient’s Oxford Knee Score (OKS). Recent therapies including treatment with microfragmented adipose tissue (MFAT) have emerged as alternatives to relieve pain and improve function in such patients. Method. We identified all patients with KOA Kellgren-Lawrence grade 3 and 4 in our dataset of patients treated with a single injection of MFAT and applied published OKS thresholds for referral for TKR to separate them into 3 cohorts according to their functional impairment. 220 patients (95 females, 125 males) with KOA were given one MFAT injection. The function (OKS) and quality of life (EuroQol-5) prior to and 24 months after therapy were compared. Results. MFAT injection provided a statistically significant improvement in the quality of life (EQ-5D) at 24 months in patients with a baseline OKS of 39 or less (p value: <0.001) as well as those with OKS of 27 or less who are deemed suitable for a knee replacement (p value: <0.001). Conclusion. MFAT injection improves quality of life in patients with KOA who are deemed suitable for the knee replacement. MFAT is a low-morbidity alternative biological treatment and can delay the need for total knee replacement in suitable patients.http://dx.doi.org/10.1155/2021/9921015 |
| spellingShingle | Nima Heidari Tiffanie-Marie Borg Stefano Olgiati Mark Slevin Alessandro Danovi Brady Fish Adrian Wilson Ali Noorani Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years Stem Cells International |
| title | Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years |
| title_full | Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years |
| title_fullStr | Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years |
| title_full_unstemmed | Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years |
| title_short | Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years |
| title_sort | microfragmented adipose tissue injection mfat may be a solution to the rationing of total knee replacement a prospective gender bias mitigated reproducible analysis at two years |
| url | http://dx.doi.org/10.1155/2021/9921015 |
| work_keys_str_mv | AT nimaheidari microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT tiffaniemarieborg microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT stefanoolgiati microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT markslevin microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT alessandrodanovi microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT bradyfish microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT adrianwilson microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears AT alinoorani microfragmentedadiposetissueinjectionmfatmaybeasolutiontotherationingoftotalkneereplacementaprospectivegenderbiasmitigatedreproducibleanalysisattwoyears |