- Procedure involves removing a small amount of fat from the patient’s abdomen
- The removed tissue is then ‘washed’ to look for and separate out pericyte cells
- The harvested cells are then injected directly into the knee
An injection of cells from a patient’s own stomach fat could end the agony of arthritis in the knee. The experimental procedure involves removing a small amount of fat from the patient’s abdomen with a fine, hollow metal tube called a cannula.
The removed tissue is then ‘washed’ to look for and separate out pericyte cells, which are found in the lining of blood vessels in fat.
These work like stem cells, which are well-known for their healing properties – encouraging tissues to repair and regenerate.
Joint effort: How an arthritic knee is soothed and healed by the fat cells
The harvested cells are then injected directly into the knee to help reduce inflammation and mend damaged knee cartilage caused by arthritis. Patients can go home the same day, and go back to work the following day.
Early research carried out on 20 patients with osteoarthritis, and presented at the International Cartilage Repair Society meeting in Sorrento last September, found the £6,000 procedure reduced pain and significantly increased activity in most patients.
After two years, pain dropped from severe to mild and activity score increased, according to the study presented by Polish orthopaedic surgeon Konrad Slynarski, who has carried out more than 200 procedures since 2014.
The 90-minute technique, available privately in the UK, is called Lipogems and is carried out under local anaesthetic. Professor Adrian Wilson, an orthopaedic surgeon in Harley Street, London, who is offering the procedure said: ‘Body fat contains a very high concentration of perictyes – pre-stem-cells that sit in the blood vessels in fat.
‘Once they develop into stem cells they encourage the formation of new blood vessels which helps with healing. By using body fat you get 100 times more regenerative cells than you would, for example, from bone marrow.’
Professor Wilson has treated 12 arthritis patients with the Lipogems technique since last November. All but one saw an improvement in their condition, he says.
After two years, pain dropped from severe to mild and activity score increased
About 50ml of fat tissue is removed for each knee from the abdomen or other parts of the body such as the flank or buttocks. The cells are then placed in a ‘cocktail shaker’ type device filled with saline and shaken by hand for 30 seconds, five to ten times until the saline and fat cells separate.
Once separated, the cells are injected into the fluid-filled knee cavity using scans to direct the doctor to the site of the arthritis.
During the 24 hours after the procedure, the cells are absorbed into the fluid of the knee ready to help with healing, reducing inflammation and regenerating cartilage.
Patients normally see an improvement after four to six weeks. ‘Treatment of patients with arthritis normally involves weight loss, physiotherapy, steroid injections and then surgery,’ said Professor Wilson. ‘However, there is only an 80 per cent chance that surgery will work. This procedure may be suitable for patients with early or moderate disease, who don’t yet need a knee replacement.’
Among the first British patients to undergo the technique is retired businessman Ernst Schiel, 77, from Oxshott, Surrey. The keen skier, tennis player, mountaineer and sailor had arthritis in both knees.
He had a partial knee replacement privately on his left leg last year which was very successful, but was still having pain in his right knee, making walking difficult.
Reluctant to offer another knee replacement because Mr Schiel had suffered blood clots twice in the past, Professor Wilson suggested a Lipogems injection.
Ernst had the injections in both knees in January this year, and immediately felt better.
‘From the next day onwards, I felt pain-free and could move freely like a fit 60-year-old,’ says Ernst.
‘I played tennis and golf within a week, and spent five weeks skiing without any problems.’
Dr Natalie Carter of Arthritis Research UK, said: ‘There is a desperate need for better treatment and support. But we urge caution to patients considering stem cell treatments like this, as the treatment is not approved by NICE and more research is needed.’