Adinizer-Processed Microfragmented Adipose Tissue With Ligament-Targeted Prolotherapy for Acute-on-Chronic Kellgren-Lawrence Grade III Knee Osteoarthritis: A Case Report With 22-Month Follow-Up.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Knee osteoarthritis is increasingly understood as a whole-joint disorder involving not only articular cartilage but also subchondral bone, synovium, menisci, capsule, ligaments, periarticular entheses, and neuromuscular control. In patients with pre-existing degenerative osteoarthritis whose symptoms worsen after an injury-related episode, treatment strategies focused only on the intra-articular cartilage environment may not adequately address coexisting ligamentous or capsular pain generators. Microfragmented adipose tissue has been explored as an autologous orthobiologic option for symptomatic knee osteoarthritis, while dextrose prolotherapy has been used for chronic musculoskeletal pain and ligamentous or capsular pain generators. We report the case of a 63-year-old woman with symptomatic right knee osteoarthritis who presented with a 12-month history of right knee pain beginning in May 2023, which worsened after a walking-related injury episode. She had osteoporosis, dyslipidemia, gastroesophageal reflux disease, a history of breast cancer surgery, and previous contralateral unicompartmental knee arthroplasty. Baseline radiographs demonstrated Kellgren-Lawrence grade III right knee osteoarthritis. Because she wished to delay arthroplasty due to previous postoperative pain and prolonged rehabilitation after contralateral knee surgery, she underwent intra-articular injection

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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