Prospective Treatment of First Carpometacarpal Osteoarthritis With Autologous Fat Transfer

The purpose of this study was to analyze the effect of autologous fat transfer on outcomes in patients with basilar thumb arthritis.

Twenty-three patients with carpometacarpal (CMC) arthritis underwent autologous fat transfer under fluoroscopic guidance. Autologous fat was harvested from the abdomen and separated with nonadherent gauze (Telfa). After processing, 2 mL of fat was injected into the CMC joint. All patients were placed in a prefabricated thermoplastic splint for 2 weeks postoperatively. Patients completed the Disability of Arm-Shoulder-Hand Questionnaire (DASH) questionnaire both preoperatively and postoperatively at 1, 6, and 12 months. Paired t tests were used to compare pretreatment to posttreatment DASH scores. Significance was set at a P value less than 0.05 (95% confidence interval [CI]).

The average preoperative DASH score was 51.81 (95% CI, 45.85-57.76). Average postoperative DASH score at 1-month follow-up was 26.16 (95% CI, 19.76-32.57), followed by a DASH score at 6-month follow-up of 22.49, 95% CI (15.41-29.54), and a DASH score at 12-month follow-up of 26.62 (95% CI, 17.68-35.56). Improvements in DASH score were as follows: 26.49 at 1 month postoperatively (P < 0.01), 30.64 at 6 months postoperatively (P < 0.01), and 26.89 at 12 months postoperatively (P < 0.01). No major adverse events were observed.

Autologous fat transfer for the treatment of CMC osteoarthritis significantly improved hand function in our cohort. Additional studies of fat transfer are warranted to better understand the physiologic mechanisms and therapeutic benefits.