Long-term Pain and Functional Outcomes After Micro-fragmented Adipose Tissue Injection for Meniscus Tear Compared with Normal Saline- AAP 2026

N Hogaboom, t dyson-hudson, n hager, x yuan,

Abstract accepted for poster presentation at the 2026 Association of Academic Physiatrists Annual Meeting

Objectives: Meniscus tears are one of the most common knee injuries and are often associated with pain and functional limitations.1, 2 Acute treatment includes rest, activity modification, pharmacological agents, and physical therapy. Patients refractory to conservative care often progress to corticosteroid injections and, ultimately, surgery if pain and function do not improve. Surgical efficacy is contested3, 4 and has potentially significant short- and longer-term consequences.5 Treatment with orthobiologics has shown promise, but there is no evidence to conclude their long-term effectiveness for meniscus tears. The purpose of this pilot study was to evaluate and compare patient-reported outcomes of knee pain and function up to four years after trephination and injection of either micro-fragmented adipose tissue (MFAT) or normal saline (NS).

Design: Two individuals with knee pain secondary to meniscus tears were recruited. One participant (male, age 38) was injected with 3 mL MFAT with 3 trephinations into the lateral meniscus, and 6 mL into the joint. The other (female, age 44) was injected with 1.5 mL NS with four trephinations into the medial meniscus, and 5 mL into the joint. Pain, function, and quality of life (QOL) outcomes were collected at baseline (treatment); 1, 2, 3, and 6 months; and 1- and 4-years post-injection.

Results: Both individuals reported improvements in four-year outcomes, including PROMIS Mobility v2.06 (MFAT: 8%, NS: 21.3%); Numerical Rating Scale score (MFAT: 80%, NS: 100%); PROMIS Global Physical Health v2.07 (MFAT: 11.8%; NS: 5.8%); and scores of Knee Injury and Osteoarthritis Outcome Score (KOOS)8 Symptom (MFAT: 27.3%; NS: 30.8%), Pain (MFAT: 62.5%; NS: 83.3% NS), Function (MFAT: 72.7%; NS: 100%), Sports/Recreation (MFAT: 69.2%; NS: 57.1%), and QOL subscales (MFAT: 61.5%; NS: 57.1%). Both treatments were well-tolerated with no reported adverse events.

Conclusions: While these results are promising, a larger, randomized controlled trial is needed to show efficacy for either treatment.