POSTER - #PI1013

THE ORTHOBIOLOGIC INSTITUTE (TOBI) 11TH ANNUAL ORTHOBIOLOGICS SYMPOSIUM

Intra-articular Fat Derived Stem Cell Injections Effect On Pain, Stiffness, And Function In Osteoarthritis
William Gasque, MD; Christopher Clemow, MD; Joel E. Williams, MPH, PhD; Mark Cromer, BS
AnMed Health Family Medicine Residency; Prisma Health- Blue Ridge Orthopaedics - Anderson

Objective / Main Outcome Measures:
To analyze the impact of fat derived mesenchymal (MSC) injections using a Lipogems technique on pain, stiffness, and function associated with osteoarthritis (OA). We also evaluated trends in pain medication usage, Kellgren-Lawrence (KL) scales, and correlation with leukocyte poor platelet rich plasma (lp-PRP) injections.

Design / Intervention / Participants:
A prospective observational study using questionnaires and Western Ontario and McMaster Universities Arthritis Index (WOMAC) Scores at 1 month (mo) prior to Stem Cell injections (SCI), 1 mo post SCI, and the recent month. 52 patients (86 joint injections) were treated with fat derived SCI, with/without a 1-2 week post lp-PRP injection for musculoskeletal (msk) issues (93% knee OA). WOMAC Scores were analyzed using a Within-Subject Repeated Analysis of variance (ANOVA) with alpha at .05, and a Bonferroni correction was applied.

Setting:
The clinic of a Primary Sports Medicine physician at a local orthopedic practice in Anderson, SC.
Level of Evidence: Level 2

Results:
Repeated measures ANOVA w/Greenhouse-Geisser correction determined mean Pain, Stiffness & Function Scores had statistically significant difference between (b/w) time points F(1.887, 147.162) = 130.447, P < 0.0005, F(1.944, 151.604) = 73.238, F(1.818, 141.794) = 127.568 respectively. Post hoc tests using Bonferroni correction revealed statistically significant reduction in all scores comparing pre-post: [11.18 +/- 4.54 vs 5.30+/- 4.44 (p=.000)], [4.28 +/-2.02 vs 2.38 +/-2.03], [37.32 +/-16.31 vs 17.63 +/-14.44] respectively & comparing pre-recent: [11.18 +/- 4.54 vs 3.55 +/- 3.38 (p=.000)], [4.28 +/- 2.02 vs 2.06 +/- 1.90], [37.32 +/- 16.31 vs 12.70 +/- 11.65] respectively. Only Stiffness scores didn't elicit significant difference comparing post-recent: 2.38 +/- 2.03 vs. 2.06 +/- 1.90 (p=.250). The percent differences between WOMAC (pre-recent) scores were 66.4%, 48% & 63.4% resp. 69% of patients reported reducing or stopping pain meds. KL scores of 1-3 vs 4 had greater percent differences in pain/function b/w pre-recent scores.

Conclusion:
Results showed statistically significant reduction in scores for pain, stiffness, and physical function between 1 month pre SCI and 1 month post. Score reductions continued through the recent month but were significant in pain and function. The majority of patients reported decreased pain medication usage. Less severe OA had greater improvement in pain and function. There was no significant difference reported in those receiving lp-PRP posts SCI.