kök hücre uygulamaları
In the present study, we evaluated the safety and efficacy of autologous aspirated and purified fat tissue injected percutaneously into the knee joint to treat OA symptoms. We hypothesized that the fat with its content of adiposederived stem cells (ASCs) injected into the joint, might contribute to cartilage healing and meliorate mechanical joint function. Methods Participants We retrospectively reviewed 30 patients (12 males and 18 females), who received an autologous percutaneous fat injection for the treatment of knee OA, from January 2012 to March 2015. Mean patients’ age was 63.3 5.3 years (range, 50–80 years). Body mass index was 25.1 1.7. Inclusion criteria were: stable or progressive knee OA for at least 12 months, no other injective treatments during the last 12 months, no previous knee surgeries, no infections or systemic inflammatory diseases. The diagnosis of OA was made following the American College of Rheumatology criteria and according to the classification of Kellgren– Lawrence.14,15 Patients with narcotic use, non-OA joint pain, systemic conditions, others ongoing or previous injective OA treatments, and age younger than 18, were excluded. Written informed consent was obtained from all patients before treatment after having explained all the potential risks and benefits of the purposed method and all the possible alternative therapeutic approaches. Interventions Fat was harvested from the abdomen using a 2-mm multiport small-hole cannula and was sheared into finer particles using 60 mL sterile syringe Luer–Lock with microspheres (►Fig. 1). After 7 to 10 minutes of infiltration of the donor site with Klein solution (►Fig. 2), 20 mL of fat was harvested from the abdomen (►Figs. 3 and 4), and after decantation and separation of the liquid component, 6 ml was injected into each knee (►Fig. 5) under local anesthesia. Decanted fat was injected percutaneously with 1-mm cannulas. Percutaneous access to the knee articular space was located at the superior-lateral margin of the patella. Patients were asked to avoid sports activities for 7 days after the treatment. In the postoperative period, an abdominal girdle for 15 days was applied to all patients, to reduce the formation of a local hematoma, while a pressure dressing was applied to the knee for 1 day. All the patients followed a rehabilitation protocol to improve posture and muscle toning. Fig. 1 Sterile Luer–Lock syring
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