MFAT Research Update: Stem Cells From Your Own Fat Are The Cutting Edge For Osteoarthritis

Samuel G Oltman, ND, RMSK

Impressive research continues to accumulate for treating osteoarthritis with MFAT, the adipose-derived stem cell therapy we specialize in at Cascade Regenerative Medicine. New studies are being published every month and we review them all, looking for how to provide our patients better care. Most of the studies are done on knee osteoarthritis but there are other areas that we will highlight and where the research will continue to grow. We can use MFAT in any area in the body that suffers from degeneration and/or injury.  

Knee Osteoarthritis

• A large meta-analysis of over 900 patients showed superior results with fat compared to bone marrow (the other source of adult stem cells), with more pain relief for a longer period of time. Fat-based therapy also had a lower complication rate. 

• A randomized trial of 78 patients showed that using MFAT with arthroscopic knee surgery is better than surgery alone. We will often have patients who are getting treatment right after a surgery to achieve better results. 

• A placebo-controlled study of 75 patients, provided level 2 evidence that MFAT is superior to placebo and steroid injections. Steroid injections, as discussed here, relieved pain at 2 and 6 weeks but were no different than placebo beyond that point. MFAT demonstrated significant pain relief and functional improvement through 1 year post-treatment. 

• In a prospective study of 46 patients, a success rate of 77% was demonstrated at 4 years after a single MFAT treatment. 8% of those successful cases required additional injections during the intervening 4 year study period. They also took x-rays of the patients’ knees and showed no progressive of the arthritis over the 4 year period. This demonstrates the long term effect that MFAT injections have with a single treatment. While many people do best with occasional PRP injections as maintenance, the longevity of the effect is what makes MFAT special. 

Bottom Line: MFAT works for knee osteoarthritis over the long term, with a single treatment. Not for every person every time, but the evidence is strong that the stem cells in your fat tissue hold powerful healing potential for osteoarthritis.

Shoulder Osteoarthritis

• MFAT in 25 patients with shoulder osteoarthritis improved pain and function through the one year follow up period. 

• An observational study of 65 patients who received MFAT treatment, average age 55, had sustained improvements in pain and function beyond the 3-year follow up period from a single treatment.

Tennis Elbow

• A single case study, showing the potential for MFAT to heal even severe full thickness tendon tears. Generally these are not thought of as good candidates but more and more we see cases (clinically and in the literature) demonstrating that even full thickness, retracted tendon tears can be healed with MFAT. 

We need more evidence and it needs to be higher quality. This will always be true. It is true in all of medicine. Most people do not know how shaky the evidence is for even the most common orthopedic surgeries. The current evidence makes it harder to ignore that for many people, MFAT is the best choice. See us today and find out how we can Keep You Moving. 

References:

1. Muthu S, Patil SC, Jeyaraman N, et al. Comparative effectiveness of adipose-derived mesenchymal stromal cells in the management of knee osteoarthritis: A meta-analysis. World Journal of Orthopedics. 2023;14(1):23.

2. Ulivi M, Meroni V, Viganò M, et al. Micro-fragmented adipose tissue (Mfat) associated with arthroscopic debridement provides functional improvement in knee osteoarthritis: a randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy. 2022;31(8):3079.

3. Richter DL, Harrison JL, Faber L, et al. Microfragmented adipose tissue injection reduced pain compared with a saline control among patients with symptomatic osteoarthritis of the knee during 1-year follow-up: a randomized controlled trial. Arthroscopy. Published online September 5, 2024:S0749-8063(24)00639-X.

4. Onorato F, Rucci M, Alessio-Mazzola M, et al. Autologous microfragmented adipose tissue treatment of knee osteoarthritis demonstrates effectiveness in 68% of patients at 4-year follow-up. Arch Orthop Trauma Surg. Published online January 11, 2024.

5. Vinet-Jones H, F Darr K. Clinical use of autologous micro-fragmented fat progressively restores pain and function in shoulder osteoarthritis. Regen Med. 2020;15(10):2153-2161.

6. Natali S, Screpis D, Patania E, et al. Efficacy and long-term outcomes of intra-articular autologous micro-fragmented adipose tissue in individuals with glenohumeral osteoarthritis: a 36-month follow-up study. J Pers Med. 2023;13(9):1309.

7. Siddiqui IJ, Ritner A, Mahadevan S, Dineen KJ, Desronvilles R. Regeneration of full thickness common extensor tendon tear after percutaneous microfragmented adipose graft. Regen Med. 2024;19(9-10):1-10.