Effects of Intra-Articular Autologous Adipose Micrograft for the Treatment of Osteoarthritis in Dogs: A Prospective, Randomized, Controlled Study

Abstract

The purpose of this study was to estimate the safety, feasibility, and efficacy of the intra-articular treatment of autologous microfragmented adipose tissue in dogs with spontaneous osteoarthritis (OA) in comparison with hyaluronic acid (HA), the standard intra-articular treatment. Specifically, it clinically evaluated pain and lameness, the radiographic progression of osteoarthritis, and synovial fluid inflammation. This was a prospective, single-center, parallel-group, randomized, controlled, in vivo clinical study. Participants (n = 40) received either a single intra-articular injection of microfragmented adipose tissue or a single intra-articular injection of HA (1:1). Clinical outcomes were determined using a specialistic clinician assessment obtained by the completion of a specific clinical form based on the Vesseur modified lameness classification system, a pain evaluation using the Visual Analogue Scale (VAS), the measurement of the range of motion (ROM) of the affected joint, limb circumference, and the owners’ score evaluation using the Canine Brief Pain Inventory (CBPI) for up to 6 months after the time of injection. Patients underwent a radiographic examination to establish the degree of OA in the affected joint, and synovial fluid samples were collected to assess the biochemical environment of the joint and evaluate and quantify the cellular population and the presence of three specific inflammation biomarkers for up to 60 days. The results of this study suggest that microfragmented autologous adipose tissue is safe and can effectively relieve pain and improve function in dogs with spontaneous articular OA. This one-step procedure is simple, timesaving, cost-effective, minimally invasive, and eliminates the need for complex and time-intensive cell culture processing. Furthermore, the clinical evidence and cytological results suggest better long-term pain control, resulting in an improvement in joint function, compared to HA treatment. The canine spontaneous OA model could play a key role in developing successful treatments for human medicine.

Comparative study of 1H-NMR metabolomic profile of canine synovial fluid in patients affected by four progressive stages of spontaneous osteoarthritis

“…Anesthesia was maintained with 1.2% isoflurane in oxygen for the radiographic evaluation. The radiographic examination was performed, and orthogonal projections of the affected joint were obtained from each patient to blindly assess the OA according to the modified Kellgren–Lawrence scale (Table 4 ): score 0 = normal (grade 0); score 1–3 = mild OA (grade 1); score 4–6 = moderate OA (grade 2); score 7–9 = severe OA (grade 3); score > 10 = extremely severe/deforming OA (grade 4) 13 .…”

“…Currently, OA can be detected in the later stages of the disease because it is diagnosed predominantly through clinical examination and diagnostic imaging 12 , and there is no definitive treatment that can stop the progression and cure the disease 11 . For this reason, the scientific literature has increased its interest in researching novel therapies 13 , 14 and alternative detection methods for early diagnosis and monitoring of disease activity and progression 15 .…”

Updates on mesenchymal stem cell therapies for articular cartilage regeneration in large animal models

“…Intra-articular injection of human umbilical cord matrix-derived MSCs (umMSCs) increased regenerated cartilage thickness and improved articular surface appearance on magnetic resonance imaging (MRI) ( Zhang B. Y. et al, 2018 ). Adipose tissue-derived MSCs (aMSCs) and umMSCs injections also trended towards suppressed blood/synovial inflammatory markers, including interleukin-6 and tumor necrosis factor-alpha ( Botto et al, 2022 ). Moreover, intra-articular knee injection of 10 million allogenic bone marrow-derived MSCs (bMSCs) and hyaluronic acid (HA) encouraged cartilaginous tissue formation in chondral defects on gross and histologic analysis, compared to HA or saline alone ( Li et al, 2018 ).…”

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

“…In human medicine, studies have shown the potentiality of MFAT administration in plastic surgery, wound and fistula healing, and in management of degenerative chronic diseases (osteoarthrosis and diabetes) [ 48 , 49 , 50 , 51 , 52 ]. On the other hand, the scientific literature concerning the use of MFAT in veterinary medicine is very limited [ 53 , 54 , 55 , 56 ]. To our knowledge, there have been no previous studies evaluating the effect of MFAT on bone healing in either human or veterinary medicine.…”