Regenerative Cell Therapy for Knee and Hip Pain
Lipogems® adipose tissue cell therapy is when small amounts of fatty (adipose) tissue are taken from areas of the body, such as the stomach, thighs or flanks (love handles).
Using a special process, cells are extracted from this tissue and injected into areas of your body that have become damaged through wear and tear, injury, or disease. Adipose tissue therapy can also be used as a single or additional treatment alongside other procedures to help with bone and tissue healing.
The healing power of fat
Fat plays a number of roles in our body, including how we heal. Studies carried out over many years have explored this healing potential, which was recognised as early as World War 1, when fat was used to speed up the healing of soldiers’ wounds.
Fat as part of a balanced diet is essential for our health and has many benefits alongside providing energy, including cushioning the joints and repairing damaged tissues.
The advantages of using fat to help with healing include:
There is plenty of fat in the body
It can be easily ‘harvested’ using a minimally invasive procedure carried out using a local anaesthetic or sedation.
Fat contains cells that help to heal damaged tissue
Research has shown that, no matter how old you are, fat is still able to retain its healing properties
How does it work?
The cells that are stored in your own body fat (or adipose tissue) are able to respond to problems in other areas of the body that are causing pain or dysfunction, providing natural ‘tools’ to help with healing. Your cells can help to:
Repair damaged tissue (for example, after an injury or operation)
Speed up tissue growth and regeneration
Reduce inflammation, helping tissues to heal more quickly
Improve blood flow by creating new blood vessels
Reduce areas of internal or external scarring
Is Lipogems® therapy right for me?
Our bodies have a powerful ability to heal themselves. Lipogems® adipose tissue therapy harnesses this natural repair process to treat pain and inflammation affecting the tendons, ligaments, joints and muscles, as well as helping to heal the underlying cause of the problem. It may be the right treatment for you if:
You are interested in having a minimally invasive procedure as an alternative to surgery
You have an injury or long term condition that prevents you from getting on with your everyday activities, including sport
You have pain and/or limited joint movement, for example in your knee or hip.
You have a tendon, ligament and/or muscle problem
You have already tried physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), or steroid injections and these haven’t helped to relieve your pain
You are having orthopaedic surgery and Mr Imbuldeniya believes you may benefit from having Lipogems® as an additional therapy
Lipogems® adipose tissue therapy alone is unlikely to help you if you already have advanced joint degeneration, when joint replacement surgery may be the only option. In this case Mr Imbuldeniya will be able to advise you about the best treatment options for your condition.
A step-by-step guide:
Your initial appointment
Lipogems® adipose therapy isn’t suitable for everyone. When you first contact us, you’ll be offered an initial assessment and consultation with Mr Imbuldeniya to discuss your condition in detail, perform a thorough medical examination, review any recent diagnostic tests you’ve already had and/or carry out further tests. These may include MRI scans, CT scans, and X-rays. He will then be able to advise you about whether Lipogems® adipose therapy is likely to be the right choice for you.
The procedure as with all newer treatments is not currently funded by Private Medical Insurance so you will need to consider the costs of the treatment with us.
Before your treatment, you’ll be introduced to the rest of the Lipogems® team, in particular the plastic surgeon and radiologist who will carry out the treatment. You will also meet one of our team of physiotherapists who will help you to prepare for the procedure by following a programme of exercises designed to strengthen the muscles around your joint. These are designed to help you recover as quickly as possible.
At each stage of your preparation, treatment, and follow-up you’ll have access to Mr Imbuldeniya and a multi-skilled team of professionals who can advise you about your treatment and recovery options.
What do I need to do to prepare for my treatment/procedure?
No special preparations are required, apart from making sure you drink plenty of water so you’re well hydrated on the day. Before your appointment, we’ll ask you to update us about your health, including any allergies you may have, and any medications you are taking (e.g. blood thinning medication).
What happens on the day of my procedure?
Your Lipogems® procedure will be carried out at The Queen Anne Street Medical Centre in Marylebone, London.
The procedure normally involves having a local anaesthetic (with sedation) rather than a general anaesthetic, so there is only a short recovery time and you’ll be able to return home the same day.
Treatment with Lipogems® involves three steps
Harvesting: fat is removed from your hip or abdomen by a specialist plastic surgeon. This procedure, which takes around 30 minutes, is usually carried out using a local anaesthetic while you are sedated and normally involves making two small incisions (cuts) of about 1cm to enable the fat to be removed using a water-assisted suction tool. Slimmer patients may need to have more incisions to obtain enough fat for the treatment, but you’ll have an opportunity to discuss this beforehand. Immediately afterwards, you’ll be taken to a recovery suite for around two hours. During this time, the cells will be processed.
Processing: the regenerative cells are separated from your fat tissue using the Lipogems® system. Your cells aren’t changed in any way and no other chemicals are added.
Implantation: your adipose cells are injected into the damaged area by a specialist trained in using ultrasound guidance to target the precise location in your hip or knee.
What should I expect afterwards?
Lipogems® adipose therapy doesn’t involve an overnight hospital stay or long recovery time. It’s a day case procedure, after which you’ll be able to return home.
Immediately after your treatment, you will be carefully monitored for several hours by our team of specialist nurses, to make sure that you are feeling well and the incision sites are healing correctly. One of our team of physiotherapists will see you to discuss your programme of exercises, which you’ll be able to begin around 48 hours after your treatment; these are designed to help you recover as quickly as possible.
Most people don’t need to have stitches to close the incisions which should heal naturally and will be covered with an absorbent dressing pad and compression wrap for 24-48 hours after the procedure. The wound may ‘leak’ a little for up to 24 hours; this is completely normal and you shouldn’t be concerned.
Before you leave, you’ll be given information about caring for your wound and a follow-up appointment date. You’ll also be given advice on post-operative medications.
What are the risks and side-effects?
There have been no serious reported side-effects from Lipogems® adipose treatment. However, as with any other injection, you may have some mild to moderate swelling at the affected sites.
Lipogems® treatment involves using only your own fatty tissue, with no other substances added. This means that the chances of infection or reaction to the treatment are significantly reduced. The treatment is carried out using a sterile technique; however, as with any injection or procedure, there is a slight risk of infection of about 1 in 30,000.
If you experience any side-effects such as pain, redness, swelling or pus at the injection or tissue collection site, please contact us or your own GP as soon as possible for advice.
FAQs about your procedure
‘What does the treatment entail?’
The cells that we’re interested in collecting are called Mesenchymal cells as these cells have naturally regenerative properties; there’s a very high concentration of these cells in your fat tissue, (what we call adipose tissue). Quite simply what we do in the Lipogems procedure is we remove a really small amount of your fatty tissue from your midsection. We then put this tissue in a closed loop system and wash it with a saline fluid to get rid of any of the impurities and then re-inject the tissue back in the joint being treated.
The Mesenchymal cells then get to work at regenerating and rejuvenating the damaged structure and cartilage in the joint and essentially restores the joint to however it was before you started experiencing any discomfort. The procedure itself is performed in just under one hour and you are free to leave the clinic the very same day.
‘Do I need to go under general anaesthetic?’
No, you have the option to have the procedure done under general or local anaesthetic, or to be sedated. We usually recommend that our patients are sedated as it just makes to the whole experience a little bit more comfortable.
‘How much fat do you remove?’
It’s a very small amount of fat, around 50ml, around the size of an espresso cup.
‘What is the recovery time like?’
There is a minimal recovery time associated with the procedure. We say that patients should take it easy 2-3 days post procedure. Post-op patients will experience a dull aching pain in the joint for 2-3 days, however the pain is not debilitating and can be managed with regular strength painkillers. We say that patients are then usually back to full activity within 5 days and the full effects of the treatment are felt within 5 weeks.
‘What is the success rate?’
The Lipogems technology has been around for over 2 and half years now and has been used to treat over 25,000 patients. Surgeons all over the world are reporting about 80% rate oftheir patients have significant pain relief and improvement in function in the short term, meaning the initial 1-2 years.
‘How long does the treatment last?’
In theory this should just be a one off treatment but some patients have repeat treatment if their pain and stiffness returns.
Some patients might eventually need joint replacement surgery, which in the right circumstances is incredibly successful.
‘What kind of aftercare is involved with the procedure?’
We suggest that all of our patients engage in around 10 sessions of physiotherapy post treatment to ensure the get the maximum benefit from the increased mobility the procedure has allowed for.
‘What are the benefits of this procedure over knee or hip replacement?’
The Lipogems procedure is a fantastic alternative to major replacement surgery. The procedure is minimally invasive with a minimum recovery time. You do not have to go under general anesthetic and they are comparatively priced.
‘Why do you harvest the cells from the fat tissue and not from the bone marrow?’
The harvesting of cells from bone marrow is an invasive treatment, conducted under general anesthetic that can be very painful. The mesenchamyal cells present in the fat tissue are easier and less painful to access. There is also research to show that the quality of stem cells in bone marrow decreases significantly as you get older, especially in women. Age and gender has no effect on the quality of stem cells present in fat tissue. Both methods of harvesting have been tried, tested and have proven to be very affective.
‘I have very severe arthritis (bone on bone), is this treatment suitable for me?’
The Lipogems technology has been used successfully on patients with all stages of arthritis, that being said, each case is unique and that is what is so important about your consultation.
Mr Imbuldeniya is a specialist in joint preservation and replacement and will be able to assess your individual suitability for the procedure. He will ensure you have the appropriate treatment options presented, bespoke to your individual needs.
‘I have recently had steroid injections, will this effect the outcome of the procedure?’
Steroid injections do not affect the outcome of the treatment however they do delay how soon you have can have the procedure done. Patients must wait 3 months after their last injection before they have to procedure. They can still come in for their consultation in the meantime though.