Fat Injections For Plantar Fasciitis?

Beth Gusenoff et al. have just published the results of their study looking into the effects of fat cell injections for patients with plantar fasciitis. Plantar fasciitis is a common musculoskeletal condition that can lead to inflammation, degeneration and thickening of the plantar fascia. Patients usually present with heel pain during weight bearing activities. The symptoms are often worse in the morning and after periods of inactivity.

There are treatments such as arch-supporting insoles, night splints, soft tissue work, acupuncture, progressive stretching and strengthening, steroid injections, etc. But, the condition sometimes becomes chronic and lingers.

This was a very small study but it showed significant improvements in pain, function and structure of the plantar fascia after receiving perforating fat injections into the plantar fascia. It’s possible that the beneficial effects may be due to a healing response from the microtrauma caused by the needle. And/or the regenerative ability of stem cells and growth factors within fat.

The authors are planning large scale clinical trials to validate their results. It would be interesting for the authors to have a control group that is exposed to the needle microtrauma without the injection of fat cells. This would help determine whether it is the fat or the microtrauma that is responsible for the positive findings.

Achilles Tendon Repair Improved By Embedding Stem Cells Into Sutures

New research published in Foot & Ankle International by Dr Samuel Adams Jr and colleagues has shown promising results with Achilles tendon repairs. They cut the Achilles tendon of rats and then performed 3 types of surgical repair:

• repair with suture only (SO)
• repair with suture plus injection of stem cells at the repair site (SI)
• repair with suture loaded with stem cells (SCS)

The Achilles tendons were analysed and tested for strength at 14 days and 28 days post surgery. The SI and the SCS groups had significantly higher ultimate failure strength than the SO group. Strength was maintained at 28 days in the SCS group but not in the SI group. Cellular analysis in the SCS group was significantly better than in the two other groups.

The findings suggest that, following surgery, the use of stem cells can enhance the healing of Achilles tendons and embedding stem cells directly into sutures offers even more benefit than injecting stem cells.