Fat grafting for pedal fat pad atrophy: A narrative review of the literature.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• 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)

Introduction Pedal fat pad atrophy involves the loss of shock-absorbing adipose tissue beneath the foot, causing pain, reduced mobility, and risk of skin breakdown. Autologous fat grafting has gained attention as a regenerative approach that restores natural cushioning rather than merely masking symptoms. Methods PubMed, Web of Science, and Google Scholar were searched through 02/01/2025 for studies on autologous fat grafting for pedal fat pad atrophy of any etiology. Data regarding pain relief, functional outcomes, complications, and comparisons with orthotics, dermal fillers, silicone implants, and allograft adipose matrix were examined. Results Autologous fat grafting demonstrated substantial, sustained pain reduction and improved foot function in multiple studies. Randomized trials showed superior outcomes over conservative management, with decreased pain scores and enhanced mobility persisting up to two years post-procedure. Imaging assessments indicated stable or redistributed graft volume correlating with long-term symptom relief. Complications were minimal, typically limited to minor bruising or temporary discomfort. Comparisons revealed that while dermal fillers provide short-term cushioning and silicone implants pose regulatory concerns, allograft adipose matrix also exhibits regenerative effects similar to autologous fat grafting but without donor-site morbidity. Con

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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