Effects of Autologous Microfragmented Adipose Tissue on Healing of Tibial Plateau Levelling Osteotomies in Dogs: A Prospective Clinical Trial

Abstract

The aim of this study was to evaluate the effects of autologous microfragmented adipose tissue (MFAT) applied after mechanical fragmentation and assess these effects radiographically in bone healing in dogs subjected to tibial plateau levelling osteotomy (TPLO). Twenty dogs with unilateral cranial cruciate ligament disease were enrolled and randomly assigned to the treatment group (MFAT) or the control group (NT). The MFAT group underwent TPLO and autologous MFAT intra-articular administration, while the NT group underwent TPLO alone. Adipose tissue was collected from the thigh region, and MFAT was obtained by mechanical fragmentation at the end of the surgery. The patients were subjected to X-ray examination preoperatively, immediately postoperatively (T0), and at 4 (T1) and 8 (T2) weeks postoperatively. Two radiographic scores that had previously been described for the evaluation of bone healing after TPLO were used. A 12-point scoring system (from 0 = no healing to 12 = complete remodelling) was used at T0, T1, and T2, while a 5-point scoring system (from 0 = no healing to 4 = 76–100% of healing) was used at T1 and T2. The median healing scores were significantly higher at T1 and T2 for the MFAT group compared with the NT group for the 12-point (p < 0.05) and 5-point (p < 0.05) scoring systems. The intra-articular injection of autologous microfragmented adipose tissue can accelerate bone healing after TPLO without complications.

Autologous Fat Transfer in Craniofacial Surgery

“…114 While research into MFATs impact on bone healing is still in its early phases, a preliminary animal trial has shown encouraging outcomes in canines who underwent tibial plateau osteotomy. 135 A protocol for a first in-human clinical study in alveolar cleft reconstruction has recently been described, aiming to assess the safety of utilizing MFAT to enhance the osteoinductive capacity of Biphasic Calcium Phosphate (BCP). 136 Supporting this direction, Benzi et al 115 have suggested that MFAT may be a safe and viable option to enhance bone regeneration in the setting of oral atrophy, though they emphasize the need for large-scale studies to validate this approach.…”

Adipose-Derived Stem Cells: Angiogenetic Potential and Utility in Tissue Engineering

“…Bone TE: The ability of ADSCs to differentiate into osteoblasts and to produce various growth factors and cytokines that stimulate the proliferation and differentiation of osteoprogenitor cells is used in TE to regenerate bone tissue in cases of bone defects, fractures, nonunion or delayed union [131][132][133][134]. ADSCs have also been shown to promote angiogenesis, which is crucial for supplying nutrients and oxygen to the healing or degenerative bone, or ADSCs may enhance the activity of bone marrow stem cells, encouraging in this way bone regeneration [135][136][137]. Even more, ADSCs can be combined with scaffold materials to promote bone growth and reduce immune responses in allotransplantation [138,139].…”