Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Study.

Background: Most surgeries for CMC joint osteoarthritis of the thumb irreversibly alter or destroy the anatomy. There is a high demand for minimal invasive alternatives. We report the results of autologous fat transfer for treatment of thumb CMC joint osteoarthritis. Methods: In a prospective study 50 patients with thumb CMC joint osteoarthrits were observed for one year after autologous fat transfer. Manual liposuction and centrifugation was performed. Pain rating as per visual analog pain scale (VAS), objective force of pinch grip and fist closure and DASH scores before and after the treatment were analysed. Results: The average preoperative pain in grade 2[degrees] patients was 7.7 (SD 1.3) and 1.8 (SD 1.9) after six and 2.4 (SD 3.1) and twelve months. Patients with grade 2[degrees] osteoarthritis demonstrated a superior benefit from this treatment as compared to patients with either 3[degrees] or 4[degrees] thumb CMC joint osteoarthrits. There were similar improvements for the parameters strengh and DASH score. No serious adverse events were observed. Conclusions: Autologous fat transplantation is an appealing alternative especially in early stage basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients in comparison to classical procedures like trapezectomy and the superior long term results in comparison to classical injection therapy makes this approach feasible as a first line therapy in early stage basal joint osteoarthritis of the thumb. (C)2017American Society of Plastic Surgeons

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