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Genes (Basel). 2017 Oct 13;8(10). pii: E270. doi: 10.3390/genes8100270.

The Effect of Intra-articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis.

Hudetz D1,2,3, Borić I4,5,6, Rod E7, Jeleč Ž8, Radić A9, Vrdoljak T10,11, Skelin A12,13, Lauc G14,15, Trbojević-Akmačić I16, Plečko M17, Polašek O18,19, Primorac D20,21,22,23,24,25,26.

Author information

1
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. ortohud@gmail.com.
2
Clinical Hospital "Sveti Duh", 10000 Zagreb, Croatia. ortohud@gmail.com.
3
School of medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia. ortohud@gmail.com.
4
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. igor.boric@svkatarina.hr.
5
School of Medicine, University of Split, 21000 Split, Croatia. igor.boric@svkatarina.hr.
6
University of Rijeka, Medical School, 51000 Rijeka, Croatia. igor.boric@svkatarina.hr.
7
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. eduard.rod@svkatarina.hr.
8
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. zeljko.jelec@svkatarina.hr.
9
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. andrej.radic@svkatarina.hr.
10
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. trpimir.vrdoljak@svkatarina.hr.
11
Clinical Hospital "Sveti Duh", 10000 Zagreb, Croatia. trpimir.vrdoljak@svkatarina.hr.
12
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. andrea.skelin@svkatarina.hr.
13
Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia. andrea.skelin@svkatarina.hr.
14
Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia. glauc@genos.hr.
15
Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia. glauc@genos.hr.
16
Genos Glycoscience Research Laboratory, 10000 Zagreb, Croatia. iakmacic@genos.hr.
17
School of Medicine, University of Zagreb, 10000 Zagreb, Croatia. mihovil.plecko@gmail.com.
18
School of Medicine, University of Split, 21000 Split, Croatia. ozren.polasek@mefst.hr.
19
Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia. ozren.polasek@mefst.hr.
20
St. Catherine Specialty Hospital, 49210 Zabok/ 10000 Zagreb, Croatia. draganprimorac2@gmail.com.
21
School of medicine, JJ Strossmayer University of Osijek, 31000 Osijek, Croatia. draganprimorac2@gmail.com.
22
School of Medicine, University of Split, 21000 Split, Croatia. draganprimorac2@gmail.com.
23
Gen-info, 10000 Zagreb, Croatia. draganprimorac2@gmail.com.
24
Children's Hospital Srebrnjak, 10000 Zagreb, Croatia. draganprimorac2@gmail.com.
25
Eberly College of Science, The Pennsylvania State University, University Park, State College, 16802 PA, USA. draganprimorac2@gmail.com.
26
The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, 06516 CT, USA. draganprimorac2@gmail.com.

Abstract

Osteoarthritis (OA) is one of the leading musculoskeletal disorders in the adult population. It is associated with cartilage damage triggered by the deterioration of the extracellular matrix tissue. The present study explores the effect of intra-articular injection of autologous microfragmented adipose tissue to host chondrocytes and cartilage proteoglycans in patients with knee OA. A prospective, non-randomized, interventional, single-center, open-label clinical trial was conducted from January 2016 to April 2017. A total of 17 patients were enrolled in the study, and 32 knees with osteoarthritis were assessed. Surgical intervention (lipoaspiration) followed by tissue processing and intra-articular injection of the final microfragmented adipose tissue product into the affected knee(s) was performed in all patients. Patients were assessed for visual analogue scale (VAS), delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and immunoglobulin G (IgG) glycans at the baseline, three, six and 12 months after the treatment. Magnetic resonance sequence in dGEMRIC due to infiltration of the anionic, negatively charged contrast gadopentetate dimeglumine (Gd-DTPA2-) into the cartilage indicated that the contents of cartilage glycosaminoglycans significantly increased in specific areas of the treated knee joint. In addition, dGEMRIC consequently reflected subsequent changes in the mechanical axis of the lower extremities. The results of our study indicate that the use of autologous and microfragmented adipose tissue in patients with knee OA (measured by dGEMRIC MRI) increased glycosaminoglycan (GAG) content in hyaline cartilage, which is in line with observed VAS and clinical results.

KEYWORDS:

adipose tissue; cartilage; dGEMRIC; glycosaminoglycans; knee osteoarthritis; mesenchymal stem cell; regenerative medicine

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