A pilot study to evaluate micro-fragmented adipose tissue injection under ultrasound guidance for the treatment of refractory rotator cuff disease in wheelchair users with spinal cord injury

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2021.1903140 · Published: January 1, 2021

Spinal Cord Injury Orthopedics Regenerative Medicine & Stem Cells

Simple Explanation

This study explored a new treatment for shoulder pain in wheelchair users with spinal cord injury (SCI) called micro-fragmented adipose tissue (MFAT) injections. MFAT involves injecting processed fat tissue into the shoulder to help with pain and healing. The study checked if this treatment was safe and if it seemed to help reduce shoulder pain. The results showed that MFAT injections appeared to be safe and helped reduce shoulder pain in the participants, suggesting it could be a useful treatment option.

Study Duration

12 Months

Participants

Ten wheelchair users with chronic SCI

Evidence Level

Pilot clinical trial

Key Findings

1
There were no significant adverse events throughout the study period.
2
WUSPI, NRS, and BPI-I7 scores were significantly lower 6 and 12 months post-procedure (P < .05).
3
All but one participant reported improvement in clinical status.

Research Summary

This pilot study investigated the safety and efficacy of micro-fragmented adipose tissue (MFAT) injections for treating refractory shoulder pain caused by rotator cuff disease in wheelchair users with spinal cord injury (SCI). The study found no significant adverse events and significant improvements in pain and function scores (WUSPI, NRS, BPI-I7) at both 6 and 12 months post-procedure. The researchers concluded that MFAT injection under ultrasound guidance is potentially a safe and efficacious treatment for refractory shoulder pain caused by rotator cuff disease in wheelchair users with SCI, warranting a larger randomized controlled trial.

Practical Implications

Potential New Treatment Option

MFAT injections may offer a new treatment option for wheelchair users with SCI who experience chronic shoulder pain and have not found relief from conservative treatments.

Improved Quality of Life

Significant reductions in pain and improvements in function suggest that MFAT injections could improve the quality of life for individuals with SCI and shoulder pain.

Basis for Larger Trials

The positive outcomes and safety profile established in this pilot study provide a foundation for conducting larger, randomized controlled trials to further validate the efficacy of MFAT injections.

Study Limitations

1
The study consisted of a convenience sample of mostly white males, so was limited with respected to its diversity in race and sex.
2
Changes in wheelchair seating or set-up or changes in types/levels of activity, all of which are factors that could have impacted changes in shoulder pain over the duration of the study were also not measured.
3
Physical examination maneuvers have limited clinical utility for diagnosing rotator cuff disease.

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