A. Di Martino (Bologna, IT)

Rizzoli Orthopaedic Institute IX Division
Alessandro Di Martino; MD; is an orthopaedic surgeon; expert on knee surgery with special focus on degenerative diseases and new treatment for cartilage and meniscus regeneration and OA prevention. He received his M.D. degree by the University of Studies of Campania Luigi Vanvitelli and completed the Residency Program in Orthopaedic and Traumatology in the same University. In 2004; he started a fellowship at the Department of Orthopedic Surgery at the James Paget Hospital in Great Yarmouth; England; where he performed outpatient and inpatient activities. In 2005; Dr. Di Martino started his activity in Orthopedic Rizzoli Institute. The main research activity is focused on translational and clinical research for the application and development of novel musculoskeletal tissue treatments; regenerative medicine; and minimally invasive surgical techniques. He is Principal Investigator in several research projects centered on the use of Stem Cells and Platelet Rich Plasma (PRP). He take and took part in 31 research project or clinical trial. Member of several scientific societies (member of Cartilage Board of SIGASCOT Italian Society of Knee Arthroscopy Cartilage Sport and Orthopaedic Technology). Author of numerous papers on international pre-reviewed Journals (H-index 28). He presented his research works in several national and international meetings of Regenerative Medicine and Orthopaedics. Winner of “Hightly Cited Research” award in 2016 by The Knee Journal. Coauthor of paper award in 2016 by Arthroscopy Journal (The Journal of Arthroscopic and Related Surgery) with Certify for “Highly Cited Research”. Poster Award Cum Laude; ICRS World Congress; 2015 and 2013.

Presenter Of 1 Presentation

Podium Presentation Osteoarthritis

10.3.4 - MF-AT Versus PRP for the Treatment of Knee Osteoarthritis: A Prospective RCT at 2-Year Follow-up

Presentation Topic
Osteoarthritis
Date
13.04.2022
Lecture Time
13:00 - 13:00
Room
Bellevue
Session Type
Free Papers
Disclosure
No Significant Commercial Relationship
ICRS Award
Magna Cum Laude

Abstract

Purpose

No high-level studies investigated the potential of micro-fragmented adipose tissue (MF-AT) over other biological products like platelet-rich plasma (PRP). The aim of this randomized controlled trial (RCT) was to compare a single injection of MF-AT to PRP in terms of clinical outcome and disease-modifying properties in patients with symptomatic knee OA.

Methods and Materials

A total of 118 knee OA patients were randomly assigned to a single intra-articular MF-AT vs PRP injection and evaluated before the injection and at 1-3-6-12- 24 months with the IKDC subjective score, KOOS subscales, EQ-VAS, EQ-5D, and VAS pain. The treated knees were also evaluated at baseline and at 6-12-24 months of follow-up with radiographs and high-resolution MRI with the WORMS.

Results

Both MF-AT and PRP provided a statistically significant improvement up to the last follow-up of 24 months. No differences were found between MF-AT and PRP groups in terms of adverse events (18.9%vs10.9%), failures (15.1%vs25.5%), and all clinical outcomes at all follow-ups. Radiographs and MRI findings did not show significant changes after the injection, neither as improvement, nor as disease progression, with no intergroup difference. Patients with moderate/severe OA treated with MF-AT showed a significantly higher IKDC improvement at 6 months compared to PRP (15.7±19.0 vs 8.6±14.2, p=0.041). Similarly, more patients with moderate/severe OA treated with MF-AT reached the MCID for the IKDC subjective score at 6 months compared to the PRP group (75.0%vs34.6%, p=0.005).

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Conclusion

A single intra-articular injection of both MF-AT and PRP provided a significant clinical improvement up to 24 months in patients with symptomatic knee OA. Both treatments showed a comparable low number of failures and adverse events, without signs of disease progression. Overall, no differences could be documented in both clinical and imaging results between the two biological approaches. Compared with PRP, MF-AT provided a higher clinical improvement at 6 months in moderate-severe OA.

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