Plastic and reconstructive surgery | 2019
One-year outcomes of intraarticular fat transplantation for thumb carpometacarpal joint osteoarthritis - case review of 99 joints.
Abstract
BACKGROUND\nThis study aims to present a new therapeutic option for the treatment of thumb carpometacarpal (CMC1) osteoarthritis (OA). Knowing that autologous fat may be beneficial for OA through anti-inflammatory and chondroprotective effects, we transplanted autologous adipose fat into the CMC1 joint with the objective to postpone definite resection arthroplasty surgery.\n\n\nPATIENTS AND METHODS\nIn this pilot study we performed surgery on 99 joints. The study population consisted of patients with symptomatic and radiologically confirmed OA of CMC1 joint. After harvesting abdominal adipose tissue, 1-2 mL of fat without physical or enzymatic manipulation were transplanted into the CMC1 joint. Surgical outcome was quantified by use of the Michigan Hand Outcome Questionnaire (MHQ) as well as strength and pain measurements during a 12-month follow-up consultation. We conducted Friedman s ANOVAs to gauge the differences over time regarding MHQ and pain under stress.\n\n\nRESULTS\nFrom two weeks on there was a pain relief, both under stress and at rest. Friedman s ANOVAs revealed a significant change in pain under stress (Chi (5) = 68.52, p<0.001). Postoperative MHQ Scores significantly improved over 12 months (Chi (5) = 90.56, p<0.001).\n\n\nCONCLUSION\nOur preliminary findings suggest that intraarticular autologous fat transplantation is a promising alternative treatment of CMC joint OA of the thumb.