Intra-articular fat grafting for pain relief and functioning improvement in patients with knee osteoarthritis: systematic review

Purpose: This systematic review critically assesses intra-articular autologous adipose tissue infiltration in knee osteoarthritis (OA) patients, providing an updated overview of this evolving therapeutic approach. Materials and methods: We performed a literature search using PubMed, Cochrane Library, PRSJ, and Medscape with the search terms: "Fat grafting", "Lipofilling", "Microfat", "Nanofat" combined with "Knee" and/or "Osteoarthritis" and focusing on studies pertaining to fat grafting in knee OA. International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42024615520. Results: Out of the 460 screened articles, only 15 (3,3%) met our criteria. All studies under review consistently recorded clinical and instrumental outcomes after a fat grafting procedure. General features, fat grafting type, follow-up, intervention specifics, outcome measures, and clinical findings are reported. All the papers showed the emerging and promising role of nanofat grafting as a therapeutic strategy for managing OA. Conclusion: Intra-articular fat grafting appears to be an effective strategy in the treatment of knee osteoarthritis. Overall findings encourage further research to validate the efficacy and safety of nanofat in OA treatment.