Fat Grafting for Pedal Fat Pad Atrophy in a 2-Year, Prospective, Randomized, Crossover, Single-Center Clinical Trial

Minteer, Danielle M.; Gusenoff, Beth R; Gusenoff, Jeffrey A.

doi:10.1097/prs.0000000000005006

Cited by 15 publications

(15 citation statements)

References 15 publications

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“…However, these studies are even finding adequate pain relief once the thickness of the foot has returned to preprocedure baseline. 18,20 This continued pain relief suggests an additional mechanism contributing to analgesia and validates the use of AFG over a simple shoe pad for more significant results.…”

Section: Pedal Injurysupporting

confidence: 53%

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Autologous Fat Grafting: Evaluation of Efficacy in Pain Relief

Klomparens

Simman

2022

Plastic and Reconstructive Surgery - Global Open

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Introduction: Autologous fat grafting (AFG) has been used in reconstructive plastic surgery for over a century. Although it has obvious benefits to the aesthetic appearance of many reconstructive surgeries, less appreciated advantages of fat grafting have also been shown in potential pain reduction. This can be seen across the board from head to toe with examples ranging from facial nerve injury to pedal atrophy and foot ulcers. The purpose of this literature review is to evaluate the efficacy of AFG for pain relief in various indications and serve as a reference for clinicians to gain insight on potentially beneficial therapies for their patients. Methods: A broad literature review was performed to analyze the various uses of AFG for pain management by various indications including postmastectomy pain syndrome, scar pain, neuromas, chronic wounds and many more. The PubMed, Science Direct and Scopus online databases were searched using keywords such as “autologous fat grafting,” “reconstruction,” “pain,” and “therapy.” Results: At this point, there is decent evidence to support AFG’s role in pain resolution in postmastectomy pain syndrome, neuropathic scar pain, and pedal injury. There is also ample low-level evidence for pain efficacy in autoimmune diseases, neuromas, vulvar lichen sclerosis, burns, and radiation-induced wounds. Conclusions: While there is a clear lack of higher-level evidence based studies conducted on AFG for all indications, the existing literature shows a definite trend of reconstructive efficacy and pain management that can be clearly appreciated. With the increasing popularity of this procedure for reconstruction, higher-level studies are beginning to take place pertaining to AFG’s efficacy not only in reconstruction, but pain management as well.

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Section: Pedal Injurysupporting

confidence: 53%

“…Recently, work has been done, as detailed in Figure 5 , to attempt to relieve this pain with AFG. 18 – 20 …”

Section: Results By Indicationmentioning

confidence: 99%

Autologous Fat Grafting: Evaluation of Efficacy in Pain Relief

Klomparens

Simman

2022

Plastic and Reconstructive Surgery - Global Open

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“…The technique for fat injection utilized the Coleman method and is described in our previous reports on foot fat grafting. 2 , 3 There were no differences between the intervention and control groups in our previous studies.…”

Section: Methodsmentioning

confidence: 67%

“…Previous publications have shown the effectiveness of autologous pedal fat grafting at achieving long-lasting improvements in pain and function for patients with pedal fat atrophy. 2 , 5 The thickness of the fat pad is initially increased and then returns to baseline with long-term increases in the volume of the fat pad distributed around the metatarsal head. 3 Other benefits of pedal autologous fat grafting to various areas of the foot have been shown, including improvement of skin quality, treating adult flatfoot deformity, and decreasing the frequency of diabetic foot wounds.…”

Section: Discussionmentioning

confidence: 99%

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Patient Selection for Pedal Soft Tissue Augmentation

Baron

Minteer

Gusenoff

et al. 2020

Aesthetic Surgery Journal Open Forum

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Background Pedal fat grafting has been shown to improve pain and functional impairment from forefoot fat pad atrophy. Objectives We aimed to determine if patient demographics and foot characteristics play a role in the level of impact that is achieved following surgery. Methods We performed a retrospective review of patients who received forefoot autologous fat injections for the treatment of pedal fat pad atrophy. Patient improvement of pain and functional impairment were evaluated for correlation with patient characteristics including gender, age, BMI, unilateral versus bilateral injections, flexible versus rigid arch, previous foot deformity or surgery, and presence of callus. Results Forty-four patients received fat injections into the ball of their foot. 73% of them were women; their mean age was 61 years and mean BMI was 26.6 kg/m2. 75% had injections performed bilaterally; 41% had a flexible arch, 73% had a past history of pedal deformity or surgery, and 43% had callus. Only female gender was found to correlate with an improvement in pain from the time of surgery to 12 months later (p=0.02). Conclusions Bilateral rigid, high arched foot type is a risk factor for foot pain and disproportionately represented among these patients. The only patient characteristic found to be correlated with improvement in pain at 12 months post-surgery was female gender. BMI and laterality of injections impacted the course of improvement after surgery. Given current data, all patients with suspected pedal fat pad atrophy should be considered for soft tissue augmentation.

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