A novel approach to osteoarthritis treatment is using the patient’s own fat to regenerate the knee.
The procedure, known as Microfragmented Adipose Tissue (MFAT) treatment, involves isolating specific cells from fat called mesenchymal stem cells.
The fat is harvested, processed then injected back into the body, with the stem cells having a regenerative effect in the area of damage.
According to The Regeneration Clinic, A London-based centre that offers the treatment, the procedure takes just 40 minutes and does not require any recovery time. Patients are told to wait five to six weeks before feeling the effects of the regeneration in the damaged area.
MFAT treatment was developed as an alternative to joint replacement; a painful operation with a recovery period that can last months.
Simon Checkley, CEO at The Regenerative Clinic, says: “In simple terms, we’re using the healing power of fat to help regenerate the damaged area in a person’s body.
“Recent studies have shown that 30% of people who have a knee replacement are actually quite dissatisfied with the outcome.
“We offer an alternative to that by offering patients a very quick and simple procedure. The patient can walk out of the hospital the very same day, go home and go back to normal life.”
In a recent study, 110 patients were assessed at The Regenerative Clinic over a 12-month period to assess the effectiveness of ‘Lipogems’, the clinic’s trademarked MFAT treatment.
The associated paper published in Stem Cells International states that 81% of people responded positively and had an improvement in their arthritis and a decrease in pain. On average, patients’ pain score improved by around 60%.
The 19% of individuals who did not respond to the treatment may have seen an initial reduction in pain in the first few months, however, this was not maintained beyond the 1-year mark.
The Regenerative Clinic says the reasons for this are not entirely clear and requires further evidence.
MFAT treatment is still in its infancy. It was first used on patients five years ago, so it is still uncertain how long the treatment remains effective.
Checkley says: “People started to use this treatment about five years ago, so we don’t know exactly how long it will last but there are studies out there that show it is still effective after five years and we have a good number of patients at the two-year point and it still effective.”
Traditional knee replacements have a lifetime of around 10 years. And because the operation is so unpleasant, the NHS will often put people’s surgery on hold to avoid repeating the operation later down the line.
For this reason, younger patients in their 50s and 60s often have to wait several years before being offered a knee replacement.
The Regenerative Clinic has so far treated over 2000 patients using Lipogems, making it the largest clinic of its kind in Europe.
The company believes the treatment could cause positive disruption in the industry, changing the traditional approach to surgery and tackling the NHS waiting lists.
Checkley says: “We think that the future of healthcare is using one’s own body to heal itself. The compounds we need are all there. It’s about using them in the right way.
“We want to see a move away from traditional surgery where you’re putting chunks of metal in people. We want to see a move away from the over-reliance on pharmaceuticals in favour of a much more naturalistic approach where we’re using the tools we have within our body to heal it. We see this as the future of medicine.”
The treatment is currently offered to private patients only and is yet to be approved by the NHS, however, the company says it would like to see it offered on the NHS in the future.
The treatment is at the beginning of this journey, with thirteen randomised clinical trials currently in progress around the world looking at MFAT treatments. The Regenerative Clinic says once these are published, the company will have the evidence it needs to approach NICE.
Checkley says: “Having our first study published is one step towards making this a more mainstream treatment that’s available to everybody.
“It’s safe, it’s effective and as the data starts to build around how long it lasts for, it also becomes cost-effective for the NHS as well. We can deliver lipogenic treatment at a much lower cost than it takes to replace somebody’s knee.”
In the long term, the Regenerative Clinic says it would like to develop treatments using stromal vascular fraction (SVF), a highly-processed form of fat.
The treatment is currently not allowed under UK regulations, however, it is being used in other parts of the world, including Panama and Thailand, to treat neurological conditions such as Parkinson’s and multiple sclerosis.
Checkley says: “We want to really look at the other diseases outside of the musculoskeletal arena that we can treat with Lipogems and the power of fat.”