Samuel G Oltman, ND, RMSK
Has your doctor told you surgery is your only option for joint pain? Micro-Fragmented Adipose Tissue (MFAT) is a therapy with growing evidence for use in osteoarthritis, one of the most common causes of joint pain as we age. Conventional care for osteoarthritis includes physical therapy, NSAIDs, and joint replacement. While I believe most people need physical therapy for optimal results, NSAIDs have long term consequences and surgery isn’t right for everyone. MFAT is an excellent alternative especially for people stuck in between physical therapy and surgery.
What is MFAT?
MFAT is a regenerative product made through harvesting the patient’s fat tissue in a simple liposuction procedure. It is then minimally manipulated through filters and a centrifuge to remove blood and oil. The final product contains progenitor cells, pericytes, mesenchymal stem cells, anti-inflammatory growth factors and a collagen matrix that all help to achieve the long-lasting pain relief seen in osteoarthritis (1, 2).
MFAT Bridges the Gap in Osteoarthritis Care
MFAT is the perfect therapy for those looking for long-lasting relief that have done physical therapy but are not yet ready for surgery. People in their 50s with plenty of cartilage in their knees or hips are often told they need joint replacement because doing PT and taking ibuprofen haven’t worked. They are told “you just need to wait until you can’t stand the pain any longer”. In the meantime they become more sedentary, gain weight, perpetuate the arthritis, and are worse surgical candidates. Even if you need to get joint replacement eventually, which many people do, what if you could reduce your pain and improve your function for the next 5-10 years with regenerative medicine?
Evidence for MFAT in Osteoarthritis
See the references at the end of this article for more information, but this is the summary: MFAT works for knee and hip osteoarthritis to reduce pain and improve function for 2+ years minimum. Many studies show 5 years of benefit after a single treatment (3, 4, 5). This has been demonstrated in patients who were already deemed eligible for joint replacement (6). MFAT works as well or better than the other source of adult stem cells, bone marrow, but without the trauma of drilling into your bone (7). MFAT is also superior to the “stem cell” products that are derived from fetal tissue like amniotic fluid and/or umbilical cord, which have no cells in them in the first place (8).
You Have Another Option
The evidence for MFAT needs to continue to grow and undergo more rigorous study. It is not in its final form as a therapeutic option. But the evidence both scientifically and clinically is strong enough to warrant a closer look by those in pain: you have more options than just ibuprofen and surgery. Even if surgery is inevitable, why wait in pain for 5+ years and be worse off on the other side of it? See an expert in the field of regenerative medicine and ultrasound-guided orthopedic injections, Dr. Samuel G Oltman, ND, RMSK, to find out what Cascade Regenerative Medicine can do for you.
Nava S, Sordi V, Pascucci L, et al. Long-lasting anti-inflammatory activity of human microfragmented adipose tissue. Stem Cells Int. 2019;2019:5901479.
Schmitz C, Alt C, Azares AR, et al. The composition of adipose-derived regenerative cells isolated from lipoaspirate using a point of care system does not depend on the subject’s individual age, sex, body mass index and ethnicity. Cells. 2022;12(1):30.
Agarwal N, Mak C, Bojanic C, To K, Khan W. Meta-analysis of adipose tissue derived cell-based therapy for the treatment of knee osteoarthritis. Cells. 2021;10(6):1365.
Heidari N, Slevin M, Zeinolabediny Y, et al. Comparison of the effect of mfat and mfat + prp on treatment of hip osteoarthritis: an observational, intention-to-treat study at one year. J Clin Med. 2022;11(4):1056.
Natali S, Screpis D, Romeo M, et al. Is intra-articular injection of autologous micro-fragmented adipose tissue effective in hip osteoarthritis? A three year follow-up. Int Orthop. 2023;47(6):1487-1492.
Heidari N, Borg TM, Olgiati S, et al. Microfragmented adipose tissue injection (Mfat) may be a solution to the rationing of total knee replacement: a prospective, gender-bias mitigated, reproducible analysis at two years. Stem Cells Int. 2021;2021:9921015.
Pintore A, Notarfrancesco D, Zara A, et al. Intra-articular injection of bone marrow aspirate concentrate (Bmac) or adipose-derived stem cells (Adscs) for knee osteoarthritis: a prospective comparative clinical trial. J Orthop Surg Res. 2023;18(1):350.
Jeyaraman M, Muthu S, Nischith DS, Jeyaraman N, Nallakumarasamy A, Khanna M. Prisma-compliant meta-analysis of randomized controlled trials on osteoarthritis of knee managed with allogeneic vs autologous mscs: efficacy and safety analysis. Indian J Orthop. 2022;56(12):2042-2059.