Suggestions for Therapy (Conservative or Surgical) before Joint Arthroplasty

**87**

**Chapter 5**

**Abstract**

*and Abdullah M. Kaki*

erative knee osteoarthritis.

sion and restore gliding [1, 2].

**1. Introduction**

cartilage degeneration, regenerative therapy repair

The Regenerative Effect of Intra-

Articular Injection of Autologous

The study started in 2010 to find the effect of autologous fat micrograft for osteoarthritis (OA); the result was published on normal animal's model, in 10 patients, then in 80 patients with knee osteoarthritis, and the current study in 205 patients. The study was conducted at King Abdulaziz University Hospital (January 2012–October 2015); 80 adult patients were suffering from moderate to severe knee osteoarthritis. About 10–20 mL fat micrograft was prepared with liposuction and injected intra-articularly into the affected knee/s. The results revealed that pain improvement after the fat injection during rest and with activity with the visual analogue scale. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) indicated improvement, both in the three domains (pain, stiffness, and physical function) and in total. The use of intra-articular autologous fat micrograft is simple, safe, and effective for degen-

**Keywords:** autologous fat micrograft, intra-articular injection, knee osteoarthritis,

Fat grafting and its use in aesthetic and reconstructive surgeries are considered a state of art, but looking back at the history, it is just a revival in the techniques, which was described previously by others when **Gustav Neuber** on 1893 was the first to perform fat graft for orbital depression in human and Erich Lexer who is a skilled German orthopedic and plastic surgeon reported a variety of clinical uses of fat graft in management of knee ankylosis and fat graft wrapped around the tendon during tendon repair to prevent skin tendon adhe-

The revolution in surgical specialty directed toward minimally invasive therapeutic modalities where endoscopic surgery replaced the open surgical operations; similarly, the recent discovery of the regenerative effect of fat micrograft due to presence of adipose-derived stem cells (ADSCs), cytokines, growth factors, pre adipocytes, and mature adipocytes led to a growing interest for the

Fat Micro-Graft in Treatment of

Chronic Knee Osteoarthritis

*Sabah S. Moshref, Yasir S. Jamal, Amro M. Al-Hibshi* 

### **Chapter 5**
