Goal of our study was to assess the clinical, imaging and histologic outcome of LIPO-AMIC technique (autologous matrix-induced chondrogenesis + ADSCs and adipose tissue transfer) consisting of osteochondral lesion debridement, microfracturing and filling with bilayer cell-free collagen scaffold soaked in adipose regenerative product.
Eighteen patients (age range: 28-58) with OCL repaired using LIPO-AMIC technique were clinically evaluated through IKDC, KOOS and VAS scores, with follow-up between 12 and 60 months. MRI examinations were performed at 6, 12 months and yearly thereafter. Adipose tissue product used in surgical procedures has been analysed in the laboratory. ADSCs, pericytes, endothelial and progenitor stem cells embedded in the extracellular matrix of the stromal vascular fraction, obtained by mechanical dissociation, have been isolated and characterized in terms of viability and cell composition using multicolor FACS analysis.
No intra or post-op important complications were encountered.
Patients showed relevant, immediate and durature improvement of various scores already from initial follow-up. At intermediate and final follow-up all scores were significantly increased (p<0.001). MRI examination, completed by T2 mapping imaging, showed early subchondral lamina regrowth and progressive maturation of the repair tissue. Histological studies shown that stem cell population resided in a perivascular location with preserved architecture and where ADSCs coexisted with pericytes and endothelial cells. FACS analysis confirmed high viability and a dramatic increased percentage of endothelial cells.
Regenerative repair of full-thickness cartilage injuries by LIPO-AMIC technique provides good to excellent clinical improvement, MRI defect filling and, at histologic evaluation, high percentage of ADSCs and endothelial cell populations with high viability and niche preservation. Results resulted improved in respect to standard AMIC technique and comparable to MACI, at significantly reduced costs.