Elisabeth M Haas1, Angelika Eisele1, Andreas Arnoldi1, Marco Paolini1, Denis Ehrl1, Elias Volkmer1, Riccardo E Giunta1. 1. From the Department of Hand, Plastic and Aesthetic Surgery, the Institute for Medical Information Processing, Biometry and Epidemiology, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, and the Department of Radiology, Ludwig- Maximilians-Universität München.
Abstract
BACKGROUND: This study aims to present a new therapeutic option for the treatment of thumb carpometacarpal joint osteoarthritis. Knowing that autologous fat may be beneficial for osteoarthritis through antiinflammatory and chondroprotective effects, the authors transplanted autologous adipose fat into the thumb carpometacarpal joint with the objective of postponing definite resection arthroplasty surgery. METHODS: In this pilot study, the authors performed surgery on 99 joints. The study population consisted of patients with symptomatic and radiologically confirmed osteoarthritis of the thumb carpometacarpal joint. After harvesting abdominal adipose tissue, 1 to 2 ml of fat without physical or enzymatic manipulation were transplanted into the thumb carpometacarpal joint. Surgical outcome was quantified by use of the Michigan Hand Outcomes Questionnaire in addition to strength and pain measurements during a 12-month follow-up consultation. We conducted Friedman's analysis of variance to gauge the differences over time regarding Michigan Hand Outcomes Questionnaire and pain under stress. RESULTS: From 2 weeks on, there was pain relief, both under stress and at rest. Friedman's analysis of variance revealed a significant change in pain under stress [chi-square (5) = 68.52; p < 0.001]. Postoperative Michigan Hand Outcomes Questionnaire Scores improved significantly over 12 months [chi-square (5) = 90.56; p < 0.001]. CONCLUSION: The authors' preliminary findings suggest that intraarticular autologous fat transplantation is a promising alternative treatment of carpometacarpal joint osteoarthritis of the thumb. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
BACKGROUND: This study aims to present a new therapeutic option for the treatment of thumb carpometacarpal joint osteoarthritis. Knowing that autologous fat may be beneficial for osteoarthritis through antiinflammatory and chondroprotective effects, the authors transplanted autologous adipose fat into the thumb carpometacarpal joint with the objective of postponing definite resection arthroplasty surgery. METHODS: In this pilot study, the authors performed surgery on 99 joints. The study population consisted of patients with symptomatic and radiologically confirmed osteoarthritis of the thumb carpometacarpal joint. After harvesting abdominal adipose tissue, 1 to 2 ml of fat without physical or enzymatic manipulation were transplanted into the thumb carpometacarpal joint. Surgical outcome was quantified by use of the Michigan Hand Outcomes Questionnaire in addition to strength and pain measurements during a 12-month follow-up consultation. We conducted Friedman's analysis of variance to gauge the differences over time regarding Michigan Hand Outcomes Questionnaire and pain under stress. RESULTS: From 2 weeks on, there was pain relief, both under stress and at rest. Friedman's analysis of variance revealed a significant change in pain under stress [chi-square (5) = 68.52; p < 0.001]. Postoperative Michigan Hand Outcomes Questionnaire Scores improved significantly over 12 months [chi-square (5) = 90.56; p < 0.001]. CONCLUSION: The authors' preliminary findings suggest that intraarticular autologous fat transplantation is a promising alternative treatment of carpometacarpal joint osteoarthritis of the thumb. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors: Trivia Frazier; Keith March; Jaime R Garza; Bruce A Bunnell; Kevin F Darr; Emma Rogers; Katie Hamel; Jeffrey M Gimble Journal: Bone Rep Date: 2022-07-06