Volumetric Analysis in Autologous Fat Grafting to the Foot. Issue 3 (September 2019)

• Record Type: Journal Article
• Authors: Ruane, Edward J.; Minteer, Danielle M.; Wyse, Aaron J.; Gusenoff, Beth R.; Gusenoff, Jeffrey A.
• Is Part Of: Plastic and reconstructive surgery. Volume 144:Issue 3(2019:Sep.)
• Publication Date: 2019-09
• Subjects: Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/PRS.0000000000005956
• Languages: English
• ISSNs: 0032-1052

Abstract

Abstract : Background: Pedal fat grafting is a safe, minimally invasive approach to treat pedal fat pad atrophy. Prior randomized controlled trials demonstrate that the fat as measured directly under the metatarsal heads disappears between 2 and 6 months after fat grafting, despite patients having relief for 2 years. The authors aim to use magnetic resonance imaging to further assess three-dimensional volume of fat in the foot after autologous fat grafting to help explain the mechanism for improved pain. Methods: A prospective study was performed using magnetic resonance imaging before and at 6 months after pedal fat grafting to assess changes in the three-dimensional morphology of the fat. Results: Seventeen patients (six men and 11 women) underwent injections with a mean volume of 5.8 cc per foot. At 6 months, patients demonstrated increased tissue thickness ( p = 0.008) and volume ( p = 0.04). Improvements were seen in pain ( p < 0.05) and activity ( p < 0.05). Foot pressures and forces were significantly decreased and positively correlated with increased fat pad volume ( p < 0.05). Conclusions: Pedal fat grafting significantly increases metatarsal fat pad volume. The distribution of the fat may contribute to lasting clinical relief in these patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.