Lipogems® Reparative Cell Therapy is Transforming Orthopedic Treatment

Groundbreaking procedure accelerates healing, improves recovery rates

Orthopedic doctors have a new option when it comes to treating conditions such as arthritis, rotator cuff tears and meniscus injuries. It entails harvesting fat from the body, which is processed and then injected into injured tissue to hasten healing and with the potential to restore and repair injured tissue. The technique is showing great promise in the field of reparative medicine and is now being used by leading orthopedic surgeons.

Dr. Joanne Halbrecht is a board certified orthopedic surgeon practicing at Halbrecht Orthopedics Biologics and Sports Medicine in Post Falls, Idaho. She has worked at the forefront of this emerging therapy for several years and is internationally recognized as an expert advocate on its techniques and merits. She is also the only orthopedic surgeon working with this type of reparative tissue therapy in Post Falls, Idaho.

In the late 1980s, Dr. Arnold I. Caplan began working with cells that had the propensity to group together, forming colonies that he exposed to different proteins that caused them to differentiate into bone, ligament or tendon tissues. He called these cells “mesenchymal” stem cells (MSCs).

Dr. Halbrecht explains that mesenchymal stem cells start out as perivascular cells, which are attached to blood vessels. “These cells can be thought of as Medicinal Signaling Cells’ that detach themselves and travel to an injury site and release a variety of chemicals that affect surrounding tissues and promote healing,” she says. “They fight inflammation, inhibit scar tissue formation, and promote tissue and blood vessel growth. MSCs have the potential to stimulate dormant cartilage cells to generate new cartilage. They are like mini-drugstores that travel where they are needed and dispense the right medicine.”

Bone marrow has been a traditional source for these cells in the past, but marrow harvesting is invasive and painful.

Today, adipose tissue is the preferred source for MSCs, which are found in higher concentration within body fat/adipose than in bone marrow. The density of adipose MSCs (the healing cells) has been reported to be up to a thousand times greater than those found in bone marrow. The age of a patient plays a part, too. The number of MSCs in bone marrow sharply declines with age, whereas the number of MSCs in adipose remains fairly constant with age.

Dr. Halbrecht uses the Lipogems® system, which harvests, processes and reinjects the refined adipose tissue during a short, in-office patient visit. She uses Lipogems-processed cells in orthopedic primary care or in tandem with surgical procedures.

Lipogems is a patented device that has earned FDA clearance for use in orthopedic surgery. It was invented by a plastic surgeon in Milan who was searching for a more gentle way to process fat used in plastic surgery.

The device is the only FDA-approved technology for processing fat in this method. This has proven to be a breakthrough in providing easily obtainable, cell-rich content for reparative therapies.

It takes about an hour to harvest and treat the cells. The extraction process can be described as a “mini liposuction.” After extraction, a saline solution runs through the Lipogems device, washing cellular debris and red blood cells out of the fat. The adipose content is rendered to a smooth consistency while retaining the structure of the original tissue. The cells are kept in a near “native” environment in order to support optimal cell function. This is an important distinction between other devices and the Lipogems technology.

The Food and Drug Administration (FDA) has mandated that any procedure of this type must not destroy the structural integrity of the source cells. Alternative mechanical and enzymatic processes—which are still in use—break up the fat cells, so they do not retain the structure of the original cells. These methods have not earned FDA clearance for use in regenerative cell therapy.

“As a patient, you need to know that there is a range of people who claim to offer regenerative cell therapy. They may not be medical doctors, and they may not be using FDA approved methods or devices. The best person to diagnose and treat a musculoskeletal  condition is an orthopedic surgeon,” Dr. Halbrecht says.

The typical patient experience involves a one-hour visit to the doctor’s office. An area of the skin is anesthetized and a small incision is made where the fat will be extracted. The doctor inserts a tube and injects a solution of Lidocaine, saline and epinephrine. This numbs the area, breaks up the fat, and inhibits bleeding. It takes about 10 minutes for the solution to have its full effect, and then the extraction is done. After the adipose is processed with the Lipogems ® system, it is injected in the area of pathology.

Because the abdomen isn’t overly sensitive, this is often chosen as the extraction site. “Most patients tell me that the extraction feels weird, but it isn’t painful,” Halbrecht explains. No sutures are needed and a compressive dressing is applied.

Clinical studies have shown MSC therapy to increase the success of rotator cuff repair.

Dr. Halbrecht has seen favorable results treating pain due to mild to moderate arthritis. “In advanced arthritis, there is often no cartilage left to work with, so this therapy would not benefit that patient.”

In a study using MSCs after meniscus surgery, some patients regenerated meniscus after treatment. “The meniscus is an important structure in the knee since it provides cushioning that prevents arthritis”, Halbrecht says. “If we can regenerate meniscus after it is removed due to a tear, we have the potential to avoid arthritis in the future.” There are no studies showing that MSCs, either derived from adipose or bone marrow will heal a torn meniscus. “Those patients still need surgery.”

Lipogems® processed adipose has been used to treat young athletes with injuries to the pectoralis, hamstring or quadriceps  muscle with positive results in as little as three weeks.

Every patient’s needs and condition are unique. But not all injuries can benefit from cell therapy. Dr. Halbrecht says, “I’ll send a patient to physical therapy if they don’t need surgery.” Once the range of motion is re-established, adipose tissue therapy may be used to augment long-term recovery.

To find out if you are a good candidate for Lipogems ® adipose tissue therapy please contact Halbrecht Orthopedics Biologics and Sports Medicine at 208-758-8893.