International Orthopaedics

, Volume 43, Issue 1, pp 15–23 | Cite as

Concentrated adipose tissue infusion for the treatment of knee osteoarthritis: clinical and histological observations

  • Ilaria RoatoEmail author
  • Dimas Carolina Belisario
  • Mara Compagno
  • Aurora Lena
  • Alessandro Bistolfi
  • Luca Maccari
  • Federico Mussano
  • Tullio Genova
  • Laura Godio
  • Giuseppe Perale
  • Matteo Formica
  • Irene Cambieri
  • Carlotta Castagnoli
  • Tiziana Robba
  • Lamberto Felli
  • Riccardo Ferracini
Original Paper



Osteoarthritis (OA) is characterized by articular cartilage degeneration and subchondral bone sclerosis. OA can benefit of non-surgical treatments with collagenase-isolated stromal vascular fraction (SVF) or cultured-expanded mesenchymal stem cells (ASCs). To avoid high manipulation of the lipoaspirate needed to obtain ASCs and SVF, we investigated whether articular infusions of autologous concentrated adipose tissue are an effective treatment for knee OA patients.


The knee of 20 OA patients was intra-articularly injected with autologous concentrated adipose tissue, obtained after centrifugation of lipoaspirate. Patients’ articular functionality and pain were evaluated by VAS and WOMAC scores at three, six and 18 months from infusion. The osteogenic and chondrogenic ability of ASCs contained in the injected adipose tissue was studied in in vitro primary osteoblast and chondrocyte cell cultures, also plated on 3D-bone scaffold. Knee articular biopsies of patients previously treated with adipose tissue were analyzed. Immunohistochemistry (IHC) and scanning electron microscopy (SEM) were performed to detect cell differentiation and tissue regeneration.


The treatment resulted safe, and all patients reported an improvement in terms of pain reduction and increase of function. According to the osteogenic or chondrogenic stimulation, ASCs expressed alkaline phosphatase or aggrecan, respectively. The presence of a layer of newly formed tissue was visualized by IHC staining and SEM. The biopsy of previously treated knee joints showed new tissue formation, starting from the bone side of the osteochondral lesion.


Overall our data indicate that adipose tissue infusion stimulates tissue regeneration and might be considered a safe treatment for knee OA.


Knee osteoarthrytis Regenerative medicine Adipose tissue Mesenchymal stem cell 



This work was supported by Compagnia di San Paolo and CRT Foundations, Banca d’Italia, and Fondazione Ricerca Molinette ONLUS. The authors thank Dr. Dario Picenoni, at SAMM (Politecnico di Milano), for his technical contribution to SEM analyses, Dr. Francesca Veneziano for immunohistochemistry.

Compliance with ethical standards

Conflict of interest

Giuseppe Perale is affiliated to the Company manufacturing the bone substitute used in this study

Supplementary material

264_2018_4192_MOESM1_ESM.docx (14 kb)
Supplementary Table 1 (DOCX 13 kb)


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Ilaria Roato
    • 1
    Email author
  • Dimas Carolina Belisario
    • 1
  • Mara Compagno
    • 1
  • Aurora Lena
    • 2
  • Alessandro Bistolfi
    • 2
  • Luca Maccari
    • 3
  • Federico Mussano
    • 4
  • Tullio Genova
    • 5
  • Laura Godio
    • 6
  • Giuseppe Perale
    • 7
    • 8
  • Matteo Formica
    • 3
  • Irene Cambieri
    • 9
  • Carlotta Castagnoli
    • 9
  • Tiziana Robba
    • 10
  • Lamberto Felli
    • 3
  • Riccardo Ferracini
    • 3
  1. 1.Center for Research and Medical Studies, A.O.U. Città della Salute e della ScienzaTurinItaly
  2. 2.Department of Traumatology and Rehabilitation, C.T.O. Hospital-A.O.U. Città della Salute e della ScienzaTurinItaly
  3. 3.Department of Surgical Sciences (DISC), Orthopaedic Clinic-IRCCS A.O.UGenoaItaly
  4. 4.Department of Surgical SciencesUniversity of TurinTurinItaly
  5. 5.Department of Life Sciences & Systems BiologyUniversity of TurinTurinItaly
  6. 6.Pathology Unit, A.O.U. Città della Salute e della Scienza of TurinTurinItaly
  7. 7.Industrie Biomediche Insubri SAMezzovico-ViraSwitzerland
  8. 8.University of Applied Sciences and Arts of Southern Switzerland – SUPSIMannoSwitzerland
  9. 9.Skin Bank, Department of General and Specialized Surgery, A.O.U. Città della Salute e della ScienzaTurinItaly
  10. 10.Department of Imaging and Radio-diagnostic, C.T.O. Hospital-A.O.U. Città della Salute e della ScienzaTurinItaly

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