About Autologous Microfragmented Adipose
Author: Sean Mulvaney, MD
Microfragmented Adipose is used in musculoskeletal medicine to focus your own body’s ability to heal. Many well-done published studies demonstrate its effectiveness and safety in treating many musculoskeletal conditions, including osteoarthritis and tendinopathies. We use a an FDA-compliant process for preparing adipose that has been in clinical use for 10 years.
Adipose (fat) is an excellent source of mesenchymal stem cells, vascular cells called pericytes and structural collagen fibers referred to as a matrix. These cells start and support the body’s own repair process. These cells bind to the injury site and release hundreds of chemical messengers, which repair the damaged tissue. Precisely injecting micro-fragmented adipose into the site of injury can kickstart the healing process.
What to Expect
We specialize in using autologous micro-fragmented adipose tissue. This means our physicians take fat from the patient’s own body.
This is a minor surgical procedure done with sterile technique. We usually get good quality adipose from the upper buttock area, but other areas, such as the abdomen, may be used. You will lay face down on a comfortable body pillow, then your skin over the liposuction area will be cleaned with a surgical skin cleaner (Chloroprep) and the area will be draped with surgical drapes.
The collection sites will be marked with a surgical marking pen, and local anesthetic will be injected at two skin entry sites. Then a tumescent solution of saline, lidocaine and a small amount of epinephrine is injected with a blunt needle into the fat below the skin. This solution helps break up the fat, numbs the area and minimizes any bleeding under the skin.
After the solution has set for at least 12 minutes and the area is numb, an adipose
collection cannula is inserted under the skin and the adipose is gently aspirated (withdrawn). This is usually a comfortable process, but you may feel a twinge or pinch during the aspiration.
The liposuction harvests a small amount of adipose, usually about 200 milliliters or less, (for comparison, a 12-ounce soda can is 355 milliliters). Rarely, there may be some small dimpling in the skin that will
even out naturally over the next six months.
The aspirated fat is then processed using the proprietary system, which gently washes the adipose with saline to remove the inflammatory oils while filtering and exposing the mesenchymal stem cells and pericytes in the adipose so they can best facilitate injury repair. Once prepared, the adipose is ready for injection.
The skin at the injection sites is numbed with a small needle and local anesthetic (buffered lidocaine). Your physician will then precisely inject the micro-fragmented adipose into the injury sites using ultrasound or fluoroscopic guidance.
Avoid NSAIDs like ibuprofen, as these suppress inflammation. Therefore, they counteract the effects of most regenerative therapies. You may use acetaminophen for mild pain.
Avoid showering for 1 day and immersion in water for 3 days after your procedure. You may remove any bandages after 1 day.
Unless otherwise instructed, the treated body part should be used and slowly moved through its full range of motion after 3 days. It will be sore, but movement will not damage it. In fact it needs to move to heal!
For the next month, avoid specific activities that hurt you before treatment.
Exercise is vital to good health and finding a way to cross train around your injury is important not only for your physical health, but for your mental health as well. Your ROSM physician and physical therapist can help you with this.
Brief heat or ice therapy will not disrupt your therapy, but should not be used for more than 10 minutes.
Depending on the injury, physical therapy is started 2 to 4 weeks after injection. Gradual improvements in pain and function should be expected 8 to 12 weeks after injection.