Fat injections could treat common cause of foot pain, plantar fasciitis


Date:
January 25, 2022
Source:
University of Pittsburgh
Summary:
A novel technique that transplants a patient's own fat into the
sole of their foot could offer relief to those suffering from a
common and painful condition called plantar fasciitis.



FULL STORY ==========================================================================
A novel technique that transplants a patient's own fat into the sole
of their foot could offer relief to those suffering from a common and
painful condition called plantar fasciitis, according to University of Pittsburgh School of Medicine researchers.


==========================================================================
In a pilot study, published today in Plastic and Reconstructive Surgery
and led by a wife-and-husband team, the fat injection procedure improved symptoms of plantar fasciitis in patients, laying the groundwork for a
larger clinical trial.

"We developed this procedure to harness the regenerative properties
of fat," said Jeffrey Gusenoff, M.D., professor of plastic surgery at
Pitt. "In this proof-of-concept study, we showed that fat injections
into the foot reduced heel pain, helped patients get back to doing
sports and activities and boosted quality of life." Plantar fasciitis,
or PF, is one of the most common causes of heel pain, affecting about 2
million people in the United States. It's caused by inflammation of the
plantar fascia, connective tissue that runs from the heel to the toes
and supports the foot arch.

"Plantar fasciitis is exceptionally painful," said Beth Gusenoff, D.P.M., clinical assistant professor of plastic surgery at Pitt. "When you get up
from a sitting position or from sleeping, it's a sharp, searing pain that
some people describe as being like a nail going right through their heel."
The acute form of PF can be treated with stretching, shoe orthotics or cortisone injections. But about 10% of patients progress to the chronic
form in which the foot's collagen degenerates and the plantar fascia
thickens. For these patients, surgical release of the plantar fascia
with a small cut can help, but this surgery comes with risks, according
to Beth Gusenoff.



========================================================================== "Recently, there has been a plea among podiatrists to stop cutting the
plantar fascia because some people get a lot of scar tissue, which
causes pain," she explained. "And if too much is cut, the foot can
become destabilized, so people end up with almost like a floppy foot."
Inspired by the regenerative properties of fat stem cells, the Gusenoffs developed a technique that uses fat harvested from a patient's belly or
other body area.

"In fat, there are stem cells and growth factors that help bring in
fresh blood supply, which drives a mode of wound healing with reduced scarring," explained Jeffrey Gusenoff. "We use a blunt needle to perforate
the plantar fascia, which makes a small injury to stimulate the healing process. Then, when we pull the needle back, we inject a little bit of
the patient's fat." To test this method, the team recruited 14 patients
with chronic PF and split them into two groups. Group 1 participants
received the procedure at the beginning of the study and were followed
for 12 months, and their Group 2 counterparts received the procedure
after a six-month observation period and were followed for an additional
six months.

"We found that Group 1 had improvements in quality of life and sports
activity, decreased plantar fascia thickness and reduced pain levels,"
said Jeffrey Gusenoff. "And a lot of the measures that were improving six months after the procedure got even better by 12 months." Similarly,
Group 2 showed decreased plantar fascia thickness and increased sports
activity six months after the procedure, and there was a slight, but
not statistically significant, improvement in pain levels. With a larger
sample size and a longer follow-up time, the researchers said it's likely
they would have seen stronger improvements in this group.

According to the Gusenoffs, this study provides proof-of-concept that
fat injections can treat PF, and they now are planning a larger clinical
trial to validate these findings. With enough evidence, they hope that
the procedure will be deemed a medical necessity so that it can be
covered by insurance and become more widely available in the future.

In previous work, the Gusenoffs showed that fat injections can help
solve another type of foot pain caused by loss of the fat pads that
cushion the ball of the foot and heel.

This research was supported by the Virginia Kaufman Pain Research
Challenge.

========================================================================== Story Source: Materials provided by University_of_Pittsburgh. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Beth R. Gusenoff, Danielle Minteer, Jeffrey A. Gusenoff. Perforating
Fat
Injections for Chronic Plantar Fasciitis: A Randomized, Crossover
Clinical Trial. Plastic & Reconstructive Surgery, 2022; 149 (2):
297e DOI: 10.1097/PRS.0000000000008765 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220125133737.htm

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