![]() The biological composition of mFAT suggests the ability of micro-fragmentation technology to reduce the presence of pro-inflammatory elements, while promoting the interaction between endothelial progenitors and MSCs/pericytes, in turn activating their anti-inflammatory and pro-regenerative potential. Moreover, mFAT contains an inferior amount of leukocytes and supra-adventitial-adipose stromal cells with respect to raw adipose tissue, along with an enrichment in endothelial progenitors, that have been described to sustain proliferation and differentiation in an interplay with tissue resident cells. This procedure empowers tissue regeneration by improving MSCs secretion of cytokines and angiogenic factors. 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. As an alternative to the use of in vitro expanded MSCs, that require extensive cell manipulation that make them advanced-therapy medicinal products (ATMPs), one step approaches based on MSCs/pericytes-derived products have been considered as promising for the treatment of knee OA. 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. 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. Knee osteoarthritis (OA) is a common condition, and a variety of conservative solutions has been proposed to control the related symptomatology. MFAT improves functional outcome and MRI appearance when used in association with AD, therefore supporting its use in the treatment of knee OA in an arthroscopic setting. Slight increase was observed in the levels of a serum biomarker of cartilage deposition (PIIINP) in both groups at 6-month follow-up ( p = 0.037). Lower T2-mapping scores were obtained in AD + mFAT-treated group in medial and lateral condyle compartments ( p < 0.001). VAS, KOOS, WOMAC and SF-12 were also collected at both timepoints, KSS only at 6 months. Additional clinical evaluation was performed at the end of the study with an average follow-up of 26.1 ± 9.5 months. Clinical, radiological and serological assessments were performed at 6 months after treatment. 78 patients affected by knee OA grade 3–4 according to KL classification were randomly assigned to AD or AD + mFAT treatment groups. ![]() This study is a prospective, randomized controlled clinical trial. 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. Nevertheless, up to today, the large part of clinical data about mFAT use refers to uncontrolled studies, especially in the surgical setting. ![]() 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. Current conservative treatments for knee OA provide limited benefits, with symptoms relief for a short amount of time. ![]()
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