Not Ready for Major Invasive Surgery?

Why do people prefer to avoid major invasive surgery?

Dr. Rogers explained, “People are trying to explore all options instead of major surgery for a variety of reasons. Some may be too young to have joint replacement surgery because we expect the results to last 20 years or less.  They may be too ill or too old to undergo a major surgery that would be considered unsafe.  Or they may just have a personal preference and are seeking a less invasive option.”.

Are steroid injections a good option if I am not ready for surgery?

Dr. Ambach noted, “Many patients are still suffering from their orthopaedic issues and have few other effective options.  Because corticosteroids are short acting pain relievers, patients might require multiple injections.  Although they are widely used, it is important to avoid corticosteroids because they have been shown in some cases to result in cartilage damage and temporary immune impairment.  Recent studies demonstrated that corticosteroid injections accelerate the loss of cartilage in the knee^1,2 and have a high complication rate (8%).^2,3 “.

Why do you use a patient’s own fat tissue for orthopaedic issues?

Dr. Rogers stated, “Fat is a very powerful tissue that has been used for medical purposes since World War I.  Fat is easy to collect from the abdomen or love handles using a minimally invasive procedure in the clinic.  Studies have shown that the quantity of important cells in the fat does not decline with age as it does with other cell sources ^3,4,5,6.

Dr. Ambach added, “A clear advantage of using one’s own tissue is the decreased likelihood for rejection or infection.  Because fat is a structural tissue, it provides cushion and support, allowing it to support healing of the damaged tissues.”.

What is Lipogems and is it FDA cleared for use in orthopedics?

Dr. Rogers explained, “Lipogems uses a patient’s own fat with a patented system that processes and resizes the tissue in just minutes.  The processed tissue is called Micro-fragmented Fat™ (MFAT) and it is injected into injured areas to help provide cushion and support the healing of damaged tissues.  I first learned about Lipogems from Dr. Arnold Caplan in 2015 and was one of the first physicians in the United States to perform this innovative therapy for a patient with knee issues.”

Dr. Ambach noted, “Lipogems provides patients with a natural, FDA cleared option that can be performed in the clinic in less than an hour using a simple procedure.  I like to use the analogy of a pothole in the road.  The pothole can be filled with asphalt and allows cars to drive over it.  MFAT is very similar, it is injected into the area where there is damaged or injured tissue and it provides cushioning to allow the area to heal naturally.”.

What are the potential benefits of Lipogems when compared with to major invasive surgery?

Dr. Ambach explained, “One of the reasons I like using the Lipogems system is that it allows multiple treatments during a single session.  Many patients are not ready for major surgery or have tried conservative options with limited relief.  Overall, there is minimal downtime from the procedure and it is an ideal option for patients that are not ready for surgery or want to avoid the hospital.”

Dr. Rogers added, “As a researcher and clinician, I have evaluated the evidence and conduct clinical studies.  More than 35,000 Lipogems procedures have been performed worldwide and report a low rate of minor complications (1-2%) and no major complications.  The procedure is economical because majority of patients only require one treatment.  In addition, Lipogems is less expensive than the out-of-pocket costs of orthopedic surgery and may be used in multiple injuries during the same day.  Even with the best insurance plans, the cost of major orthopedic surgery is more expensive and the recovery period can take months.  And, as Dr. Ambach stated, there is minimal downtime or need for pain medications.”.

Dr. Ambach noted, “My patients are happy with the procedure.  Even if they need the treatment to be repeated again down the road they are happy to do it.”

Has Lipogems been studied in any scientific research?

Dr. Rogers shared, “Lipogems is committed to delivering ethical and responsible science.  There are more than 70 research studies published in the peer-reviewed medical literature with up to 3 years of followup.  A majority of the studies performed were independently conducted at leading institutions and did not receive any company funding.  Many physicians, including myself, have presented at leading scientific and medical conferences worldwide.”.Dr. Ambach concluded, “It is important to know that each patient’s results will vary.  You may or may not need orthopedic surgery in the future.  However, you may want to try this option if you are suffering from an orthopedic condition or your surgery has been cancelled or delayed.”.

If you are interested in learning more about your options, please click here:

https://sdomg.com/contact/

REFERENCES

1. McAlindon TE et al. Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA. 2017 May 16;317(19):1967-1975.
2. Kompel A et al. Intra-articular Corticosteroid Injections in the Hip and Knee: Perhaps Not as Safe as We Thought? Radiology. Dec 2019.
3. https://www.sciencedaily.com/releases/2019/10/191015171552.htm Accessed on July 28, 2020.
4. Beane, O.S., et al. (2014). “Impact of aging on the regenerative properties of bone marrow-, muscle-, and adipose-derived mesenchymal stem/ stromal cells.” PloS one 9.12. e115963.
5. Stolzing, A., et al. (2008). “Age-related changes in human bone marrow-derived mesenchymal stem cells: consequences for cell therapies.” Mechanisms of aging and development 129.3: 163-173.
6. Kern, S., et al. (2006). “Comparative analysis of mesenchymal stem cells from bone marrow, umbilical cord blood, or adipose tissue.” Stem cells 24.5: 1294-1301.
7. Somoza RA, Welter JF, Correa D, Caplan AI. Chondrogenic Differentiation of Mesenchymal Stem Cells: Challenges and Unfulfilled Expectations Tissue Eng Part B Rev. 2014 Dec 1; 20(6): 596–608.
8. Zuk, Patricia A., et al. “Human adipose tissue is a source of multipotent stem cells.” Molecular biology of the cell 13.12 (2002): 4279-4295.
9. Caplan A: 2013: Mesenchymal stem cells environmentally responsive therapeutics for regenerative medicine.Experimental & Molecular medicine. 45(11):e54.
10. Caplan, A. I. “Why are MSCs therapeutic? New data: new insight.” The Journal of pathology 217.2 (2009): 318-324.
11. Bianchi, Francesca, et al. “A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates.” Cell transplantation 22.11 (2013): 2063-2077.
12. Bosetti et al. Human lipoaspirate as Autologous Injectable Active Scaffold for One-Step Repair of Cartilage Defects. Cell Transplant. 2016: 25: 1043-1056.
13. Tremolada C., et al. Adipose Tissue and Mesenchymal Stem Cells: State of the Art and Lipogems® Technology Development.  Current Stem Cell Reports.  2016; 2(3): 304-312.
14. https://www.prnewswire.com/news-releases/lipogems-announces-milestone-of-35-000-procedures-performed-for-patients-between-conservative-therapy-and-major-invasive-surgery-300865577.html
15. Cattaneo G, et al. Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis.  BMC Musculoskeletal Disorders. 2018: 19: 176.
16. Striano R, et al. Refractory shoulder pain with osteoarthritis, and rotator cuff tear, treated with micro-fragmented adipose tissue.  J Ortho Spine Sports Med.  2018 2(1): 014.
17. Hudetz, D, et al. The effect of intra-articular injection of autologous micro fragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis.  Genes.  2017, 8, 270.
18. Malanga G, et al. Microfragmented adipose injections in the treatment of knee osteoarthritis.  Clinical Ortho and Trauma. 2018, https://doi.org/10.1016/j.jcot.2018.10.021
19. Panchal J, et al. Safety and efficacy of percutaneous injection of Lipogems micro-fragmented adipose tissue for osteoarthritic knees.  Am J Orthop.  2018. Nov; 47(11).
20. Bisicchia, et al. Micro-fragmented stromal-vascular fraction plus microfractures provides better clinical results than microfractures alone in symptomatic focal chondral lesions of the knee. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

21. Cattaneo, G., et al. Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis. BMC musculoskeletal disorders, 2018; 19(1):176.

22. Russo et al. Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis: an update at 3 year follow-up. Journal of Experimental Orthopaedics (2017) 4:33

Disclaimer:

Individual results vary. Not all patients will have the same post-procedure recovery and activity level. See your physician to discuss your potential benefits and risks.The Lipogems System is a sterile medical device intended for the closed-loop processing of your own fat tissue in medical procedures involving the harvesting, concentrating and transferring of your own fat (adipose) tissue harvested with a legally marketed lipoplasty system. This can be a minimally invasive procedure that’s done in the office, to support soft tissue defects and may promote healing in orthopedics and arthroscopic surgery. Lipogems may or may not appropriate for all patients. Like any medical procedure, there is a risk for soreness, redness, swelling, and/or pain. These procedures require needle access (size, location and depth vary depending on the procedure) and this may result in (but not limited to), discomfort, pain, apprehension, bruising, tenderness, bleeding, swelling, or infiltration at the injection site. Other symptoms that may occur include lightheadedness, fainting, nausea, or vomiting. There is slight risk of infection at the injection site and have minimal risk of adverse reactions or complications as with any other injection procedure. Since the fat is from your own body there is little concern of disease transmission, allergic reaction or tissue rejection. For patients with chronic medical conditions such as autoimmune, diabetes, heart or lung disease, circulatory diseases or obesity, extreme caution may be necessary. There are rare but possible risks and complications due to fat transfer including an allergic reaction to the local anesthetic, damage to underlying structures, hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal), changes in sensation, unsatisfactory results that may necessitate additional procedures, permanent discoloration caused by a ruptured blood vessel at the treatment site, calcification, a divot in the area of the tissue harvest, peri-operative bleeding, a blood clot at the treatment or donor site, an infection, scar tissue, and a fat embolism caused by a fat injection mistakenly directed into a blood vessel, and death. The information presented is for educational purposes only. Speak to your doctor to decide if Lipogems procedure is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any procedure is limited and depends on several factors like patient weight and activity level. Your doctor will counsel you about strategies for your post-procedural care. It is important to closely

follow your physician’s instructions regarding post-procedure activity, treatment and follow-up care. Ask your doctor if Lipogems procedure is right for you. Lipogems or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Lipogems. All other trademarks are trademarks of their respective owners or holders.