Autologous Micro Fragmented Adipose Cells Therapy for Subtalar Joint Osteoarthritis – Case Report and Review of Literature

Introduction: Post-traumatic subtalar joint arthritis is uncommon and the majority results as a consequence of either an intra-articular calcaneal or talar fracture. A unique case of management of subtalar joint arthritis is described using autologous microfragmented adipose cells therapy. Case Report: We presented a 48-year-old male with symptomatic left subtalar joint arthritis, which was managed conservatively with analgesia and multiple steroid injections. During surgery, fat cells were aspirated from the abdomen and transferred to the Lipogems kit for mechanical breakdown of adipose tissue for around 20 minutes. Final 10ml of the product was injected into the subtalar joint. Patient was followed up at regular intervals and Visual analogue score (VAS), Manchester-Oxford Foot Questionnaire (MOXFQ) and Foot and Ankle Ability Measure scores (FAM-ADL) were collected. Results: No perioperative complications were noted relating to abdominal liposuction and intra-articular injection of lipoaspirate and during the follow-up period. Improvement in VAS, MOX FQ and FAM-ADL scores was noted up to 6 months of follow-up. Discussion: The subtalar joint plays a central role in load transmission and movement at the hindfoot and its malalignment and arthritis lead to impaired function and pain. Intra articular injections of fat cells and their regenerative potential in degenerative joint diseases have been well documented in literature. Lipogem technique has been used in knee, hip and ankle arthritis, but it is not documented to use in the subtalar joint. Conclusion: This unique case report demonstrated the successful use of a single-dose autologous micro fragmented fat cells therapy leading to functional improvement in subtalar joint arthritis with no complications.