DIGITAL OSTEOARTHRITIS TREATMENT WITH ADIPOSE TISSUE DERIVED STROMAL VASCULAR FACTOR. CASE SERIES.

Abstract

Introduction:

Digital Osteoarthritis (DOA) represents 43.3% of total cases of OA worldwide. Current medical treatments for DOA, which may consist of NSAIDs and/or SYSADOAs may provide symptomatic relief, but no curative treatment for this condition due to its degenerative nature. Therefore, with the chronic progression of the disease, medical treatment’s effectiveness may decrease, and undesirable adverse effects may also increase, provoking a decrease in the quality of life of people living with DOA.

Adipose tissue derived stromal vascular factor (ADSVF) therapy’s regenerative potential has been described since 2002. Previous clinical trials involving ADSVF infiltration in the hand had shown records of efficacy and safety in systemic sclerosis. There is evidence that ADSVF therapy for DOA produces symptomatic improvements that last from 2 to 5 years. In this case series, we describe three patients that were taking the usual DOA treatment without improvement that requested care in our clinic.

Therapeutic Intervention:

An experimental approach was proposed, consisting of the extraction of periumbilical fat via liposuction, followed by adipose tissue processing in a regenerative medicine laboratory to obtain ADSVF, which was subsequently mixed with fat micrografts. These ADSVF-enriched micrografts were infiltrated peri-articularly in the target joints.

Cases:

All three patients had clinical and radiographical manifestations of DOA. An individual assessment was made to provide care for symptomatic joints.

Patient 1, a 58 y/o female referred a preoperative Numeric Rating Scale of Pain (NRSP) scoring of 7 and 8 on the symptomatic joints. On day 180 after surgery, NRSP scoring was reduced by at least 4 points in all the treated joints.

Patient 2, a 77 y/o male had a preoperative NRSP scoring of 8 on his symptomatic joints. On day 180 after surgery, NRSP scoring was reduced to 0 in all the treated joints.

Patient 3, a 65 y/o female, had a preoperative NRSP scoring of 10 on the joints included in this study. On day 180 after surgery, NRSP scoring was reduced by at least 8 points in all the treated joints.

All the three patients referred feeling a considerable improvement in their quality of life. No complications or adverse effects related to the ADSVF infiltration have been reported.

Conclusions:

Although the fine aspects of regenerative, anti-inflammatory mechanism of action of ADSVF are yet to be elucidated, this study may stablish a framework for further clinical trials and prospective studies in Mexican population in order to provide more effective, less invasive treatment options that aim to preserve functionality and improve quality of life.