health day reporter
TUESDAY, May 17, 2022 (HealthDay News) — Liposuction is typically used to flatten your belly or shape your booty, but a new study claims it may also help people with arthritis of the fingers.
Injections of body fat into painful, arthritic finger joints appear to produce significant and lasting improvements in hand function and decreased pain, German researchers report in the May issue of the journal Plastic and Reconstructive Surgery.
People who underwent the experimental procedure started out with pain levels of 6 points on a 10-point scale, but three to four years later reported their arthritic finger pain at a median of 0.5 points, according to the results of their small-scale pilot study. The median means that half had higher pain levels, the other half lower.
“That was for us the most striking result, if you manage to decrease the pain,” said lead researcher Dr Max Meyer-Marcotty, a plastic surgeon at the Lüedenscheid Clinic in Germany. “To go from level 6 to 0.5 even after almost four years is really amazing.”
Osteoarthritis of the fingers occurs as a result of normal wear and tear. The cartilage in the finger joints breaks down and wears down over time, allowing the ends of the bones to rub together, causing pain and stiffness.
Meyer-Marcotty and his colleagues were the first to attempt this non-surgical procedure, which they began offering in 2014, he said.
They use liposuction to remove fat from the patient’s thighs or buttocks, then spin it in a centrifuge to separate the pure fat from the water, oil, and blood that is also in the sample.
Tiny amounts of fat are then injected into the patient’s aching finger joints, using X-ray monitors to make sure the syringe is getting into the right places, Meyer-Marcotty said. The procedure is called lipofilling.
“There’s no stitching, no wound closure, nothing like that,” he said. “We put a bandage on it and give it a rest for a week in a splint. Then the patient is advised to remove the splint and start moving without stress for another two to three weeks.”
By week four, the patient is able to use the treated fingers as they normally would, Meyer-Marcotty concluded.
The new article reports how the procedure performed in 28 finger joints among 18 patients treated between December 2014 and May 2015, as part of a pilot study.
Participants reported a strong reduction in pain, and researchers also noted an improvement in their ability to close their fist and grasp objects by squeezing their fingers together.
The patients experienced no infections or other complications as a result of the procedure, the researchers reported.
But Meyer-Marcotty noted that not all patients experienced relief from lipofilling.
“We have patients who benefited more or less from the first week,” he said. “We also have patients who didn’t see any improvement for two or three months and then they started to improve. And we have patients who didn’t improve at all. So that’s kind of the whole spectrum.”
Researchers also don’t know how long the relief lasts and how often a patient might need to come in for a repeat procedure.
“At this point, I’ve done repeat injections, but it’s mostly a one-time treatment,” Meyer-Marcotty said.
It’s not entirely clear why the procedure helps some patients, but Meyer-Marcotty has a few theories.
It could be that the fat simply lubricates the joints so that they function more easily, but it could also be that the stem cells in the fat cause the healing of worn cartilage or a reduction in inflammation in the joint, said Meyer-Marcotty.
German researchers aren’t the only ones studying the use of body fat to treat joint problems, said Dr. Jacques Hacquebord, associate professor of orthopedic surgery at NYU Langone in New York.
“We actually started doing a study ourselves, not for arthritis but for tennis elbow,” he said. “This concept of fat-derived stem cells is something that has been looked at and used.”
The procedure is expensive and not covered by insurance, Hacquebord said.
Whether lipofilling is worth trying depends on which usual treatment option you would otherwise choose, he added.
Steroid injections into arthritic joints are cheap, easy and effective, “so when you compare that to steroid injections, the threshold you set for yourself to show effectiveness is very high,” Hacquebord said.
On the other hand, lipofilling is much easier, cheaper and non-invasive than surgical options for finger joint arthritis, Hacquebord said. Surgical options include fusion or replacement of the joint, or transfer of tendons from other parts of the body to the fingers.
“If you say it’s going to be an improvement over surgery, that’s an easier difference to show,” Hacquebord said.
The Cleveland Clinic has more information on arthritis of the hand.
SOURCES: Max Meyer-Marcotty, MD, PhD, plastic surgeon, Clinique Lüedenscheid, Lüedenscheid, Germany; Jacques Hacquebord, MD, associate professor, Department of Orthopedic Surgery, NYU Langone, New York City; Plastic and Reconstructive Surgery, May 2022