David R Bakal1, Neal Varghis1 and Eugene Y Roh1,2*
1Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, Stanford University School of Medicine, USA 2Department of Sports Medicine, Stanford University, USAFulltext PDF
Objectives: Adipose tissue is a source of Mesenchymal Stem Cells (MSCs), which have primarily been evaluated for treatment of knee Osteoarthritis (OA). The purpose of this study was to evaluate the effect of adipose tissue hip injections at reducing pain and improving function in severe hip OA, and to assess for adverse effects. Case Report: Five patients (5 male, mean age 59.9 ± 5.9 years) with hip pain attributed to severe OA, and who had failed conservative management, underwent adipose cell harvesting followed by an ultrasound-guided adipose tissue injection into the affected hip joint. Pain and quality of life were assessed at baseline, and at 1-, 3-, 6-, 12-, and 24-months post-injection, using a Visual Analog Scale (VAS) and the International Hip Outcome Tool-12 (iHOT-12). VAS scores improved at all follow-up visits, with the greatest improvement noted at 3 months post-injection. iHOT-12 scores progressively increased throughout follow-up, corresponding to a poorer quality of life. Two participants had consultations with an orthopedic surgeon during follow-up, and one underwent a Total Hip Arthroplasty (THA). There were no significant adverse effects noted as a result of the injection. Discussion: Hip injections with adipose tissue appear to be safe and to improve pain in severe hip OA, with maximum improvement noted at 3 months post-injection. However, quality of life scores progressively worsened post-injection and one participant ultimately underwent a THA. Future studies comparing intraarticular hip injections of adipose tissue to other substances will help further elucidate their long-term efficacy at treating symptoms associated with hip OA.
Bakal DR, Varghis N, Roh EY. Adipose Tissue Injections for Severe Hip Osteoarthritis: A Case Series. Ann Clin Case Rep. 2022; 7: 2205..