Arthritic hands improve with patient’s fat injections

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An intervention –lipofilling– that consists of extracting fat from arthritis patients through liposuction, and injecting it into the joints of the fingers, can improve the function of the hands and relieve pain.

Liposuction is an aesthetic technique used to remove localized fat that accumulates in certain areas of the body, such as the belly or butt, but a team of German researchers has used it as part of a procedure that can help relieve arthritis symptoms in fingers

Rheumatoid arthritis causes inflammation of the joints, especially those of the hands, wrists, ankles, and feet, and can damage the cartilage that acts as a cushion between the bones, causing them to rub against each other, causing pain and stiffness in the joints. joints. The treatment of rheumatoid arthritis includes different types of drugs, infiltrations, and even surgery, but a study has shown that injections of the patient’s own body fat can improve the function of arthritic hands in a significant and lasting way, in addition to reducing the pain.

The procedure begins with liposuction in which fat is extracted from the patient’s thighs or buttocks, which is then centrifuged to separate the pure fat from the water, oil and blood present in the sample. Subsequently, and as explained by Dr. Max Meyer-Marcotty, plastic surgeon at the Lüdenscheid Clinic in Germany and principal investigator, small amounts of fat are injected into the patient’s finger joints, using X-ray monitors to confirm the syringe reaches the correct areas.

Patients who underwent lipofilling had pain levels of 6 points on a scale of 10 and three to four years later their arthritis pain in their fingers was a median of 0.5 points

This nonsurgical procedure is called lipofilling, and Dr. Meyer-Marcotty and colleagues were the first to try it, beginning to offer it in 2014. Patients who underwent the experimental procedure had pain levels of 6 points on a scale 10 points, but three to four years later they reported their arthritis pain in their fingers to be a median of 0.5 points, based on the results of the small-scale pilot study. Median means that half had higher pain levels and half had lower pain levels.

“That was the most surprising result for us, if you can reduce the pain, going from level 6 to 0.5 even after almost four years is really amazing”, said Meyer-Marcotty, who explains: “There are no seams, no wound closure, none of that”, we put a band-aid on him and let him rest for a week with a splint. The patient is then advised to remove the splint and start moving without stress for another two to three weeks.” The expert concludes that at week four the patient can already use the treated fingers normally.

Lipofilling is not equally effective in all patients

The results of this pilot study have been published in Plastic and Reconstructive Surgery, where the German researchers explain how this procedure worked on 28 finger joints in the 18 patients who were treated between December 2014 and May 2015. These people stated that their pain decreased significantly, and the researchers also noted an improvement in their ability to make a fist and grasp objects by squeezing their fingers. In addition, they did not experience adverse effects such as infections or other complications.

However, not all patients experienced pain relief after lipofilling. “We have patients who benefited from that from the first week or so,” but “we also have patients who didn’t see any improvement for two or three months, and then they started to improve. And we have patients who did not improve at all. So that’s the full spectrum,” said Dr. Meyer-Marcotty.

The study authors aren’t sure how long the relief this procedure provides lasts, or how often it would need to be repeated. Although they are also unclear as to why lipofilling is effective in some patients, Meyer-Marcotty suggests that the fat may simply lubricate the joints to improve their function, but that the improvement could also be due to fat stem cells contributing to the healing of worn cartilage or cause a decrease in inflammation in the joint.

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