The Use of Stromal Vascular Fraction, Platelet-rich Plasma, and Stem Cells in the Treatment of Thumb Carpometacarpal Osteoarthritis.

Background: Thumb function is integral to hand movement and overall hand function. Impairment, often caused by carpometacarpal (CMC) arthritis, reduces the quality of life. Here, we explored a novel approach using a mixture of the stromal vascular fraction, adipose-derived stem cells, and platelet-rich plasma to treat symptomatic trapeziometacarpal osteoarthritis.

Methods: Retrospective data from 30 hands of 19 patients classified as Eaton and Littler stages 1-4 were analyzed. Platelet-rich plasma and fat were collected under sterile conditions, followed by centrifugation, stem cell extraction, and injection of the mixture into the thumb CMC joint under x-ray guidance. The measurement parameters included the visual analog scale pain score, grip strength, pinch strength, and Thumb Disability Examination (TDX) score. Statistical analysis was performed using paired tests to evaluate the outcomes across the entire group, individual stages, and early/late stages.

Results: We examined 30 hands of 19 patients with trapeziometacarpal osteoarthritis. Pain reduction was significant at 6 and 24 months for all stages, particularly stages 2 and 3. Substantial pain reduction was also observed at the early and late stages. The TDX score decreased significantly in all groups after 6 and 24 months. Hand function notably improved with significant gains in tip-to-tip pinch strength at 24 months and palmar pinch strength at 6 and 24 months. No complications were observed.

Conclusions: The intra-articular injection of autologous conditioned plasma/stromal vascular fraction in patients with thumb CMC arthritis, in all stages, helps to improve pain symptoms and postpone potential resection arthroplasty with minimal surgical intervention and risks.