What Is Micro-Fragmented Adipose Tissue (MFAT)?
Adipose tissue is the medical term for body fat. To make MFAT, a small amount of fat is collected through a cannula, a thin hollow tube, in what is essentially a mini-liposuction. The fat is usually taken from the abdomen or flank. It is then gently processed and washed to break it into small clusters, without using enzymes, and injected into the joint or around the tendon being treated.
Fat tissue is rich in growth factors and in cells that support blood vessels and healing, which is why MFAT is often grouped with "stem cell" treatments. Because the tissue is processed gently, without enzymes, it keeps its natural structure. Studies of knee arthritis have reported improvements in pain and function, and MFAT gives active patients another option to explore before considering surgery.
A same-day outpatient procedure using local anesthetic and ultrasound guidance. Your physician will explain where and how it is done.
Who Is a Candidate?
MFAT may be worth discussing if you have a joint or tendon problem that has not improved enough with physical therapy, activity changes, bracing or standard injections, and you would like to consider another non-surgical option before surgery. Conditions it may be considered for include:
- Mild to moderate knee osteoarthritis
- Hip arthritis in people who are not ready for, or not yet candidates for, joint replacement
- Chronic tendon problems (tendinopathy) and some partial tendon tears around the shoulder, hip or knee
MFAT is not a replacement for surgery when a tendon is fully torn or a joint is severely damaged. It is generally not used if you have an active infection, active cancer, certain bleeding disorders, or too little fat at the collection site. Dr. Adelman, who is dual board-certified in family medicine and sports medicine (CAQSM) with advanced expertise in interventional musculoskeletal ultrasound, provides non-surgical care for arthritis and sports injuries and uses orthobiologic treatments where appropriate. She will review your history and imaging and talk with you honestly about whether MFAT makes sense for you.
What to Expect
MFAT is done as a single same-day visit. The skin and fat at the collection site, usually the abdomen or flank, are numbed with a local anesthetic, a medicine that numbs only the area being treated. Your physician makes a tiny skin opening and uses the cannula to collect a small amount of fat. Most people feel pressure and pulling rather than sharp pain.
While the fat is processed and washed, the treatment area is cleaned and numbed. Your physician uses diagnostic ultrasound to see the joint or tendon on a screen in real time and guide the needle to the right spot. The collection site is covered with a bandage and sometimes a compression wrap. The visit takes longer than a PRP injection, and your physician may ask you to arrange for someone to drive you home.
Risks and Side Effects
Because MFAT comes from your own body, allergic reactions are unlikely. Possible side effects include:
- Soreness, bruising and swelling at the harvest site, where the fat was collected
- Temporary numbness of the skin around the harvest site
- A flare of pain, swelling or stiffness at the injection site for several days
- Infection, which is uncommon
- Contour irregularity, a small dent or uneven area of the skin at the harvest site
Your physician will review these risks with you, along with any medicines, such as blood thinners, that may need to be adjusted beforehand.
Recovery
Most people return to light daily activities within a few days but are asked to limit heavy use of the treated joint or tendon for a period. You may be asked to wear a compression garment over the harvest site for a short time. Your physician will usually ask you to avoid anti-inflammatory medicines such as ibuprofen or naproxen for a period before and after the procedure, since they may interfere with the response.
Improvement typically builds gradually over several weeks to a few months as your body responds. A guided exercise program is an important part of the plan. Our physical therapists work in the same office and share your chart, so therapy can be timed around your procedure.
Physical therapy happens in our office, with therapists who share your chart. Learn about on-site physical therapy.
Insurance and Cost
MFAT is usually not covered by Medicare or commercial insurance plans, so most patients pay for it themselves. Our team can explain the cost before you decide. Your office visit and any imaging may still be billed to your insurance as usual.
When to Talk to a Specialist
Call our office if a joint or tendon problem has lasted more than a few months despite therapy and other care, or if you want to understand your non-surgical options before considering surgery. After hours, call our main number to reach the answering service.
After the procedure, go to the emergency room or call 911 for fever, spreading redness, warmth or drainage at the harvest or injection site, which can be signs of infection.
