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Purpose: This study aims to assess the effectiveness of Microfragmented Autologous Fat Tissue (MFAT) treatment for knee osteoarthritis and to investigate whether patients' pre-treatment clinical condition, such as synovitis, correlates with clinical outcomes, to identify potential predicting factors for the success or failure of the treatment. Methods: In this prospective Cohort Study Level II multicentric trial, consecutive patients with a diagnosis of early/mild osteoarthritis and failure of previous conservative measures were enrolled to undergo diagnostic arthroscopy and a single MFAT injection. Patients were assessed with repeated scoring systems at baseline, 6 months, and 12 months after surgery. The demographic features, the arthroscopic findings, the immunophenotype of injected tissue and the histologic examination of synovia of failed patients were analyzed. Results: Data from 91 patients showed a significant improvement in Lysholm, WOMAC scores at 1-year follow-up (p < 0.001). A significant decrease in VAS score was observed, while a significant improvement of measured flexion angle was registered at 1 year (p < 0.001). No major complications were reported. Age and synovitis were identified as significant factors influencing the clinical outcome (p < 0.05). Body mass index, previous or concomitant procedures, and specific cartilage defects had no influence. The mean number of injected adipose tissue-derived mesenchymal stem cells seem not to correlate with the clinical outcome. Conclusion: MFAT is effective in reducing pain when used with a single dose injection in early/mild OA of the knee, without major complications. Age over 60 and synovitis may be predictive for persistent pain at one year and should be considered before indications. [ABSTRACT FROM AUTHOR]

Silicon nitride (SiN) has been introduced clinically as an orthopedic biomaterial for interbody fusion devices and in joint replacements. However, the production of complex shapes through conventional mechanical machining is difficult and expensive and limits interesting applications. Thus, several electrically conductive reinforcements to the SiN matrix, like TiN, have been proposed, generating composites suitable to be wrought by electrical discharge machining (EDM). In this study, SiN-TiN with high strength, low density, and good electric conductivity wrought by EDM was studied. The role of surface finishing was investigated comparing the interface generated during the EDM process to that resulting from further polishing. The different topographical features were assessed by electron microscopy, energy dispersive X-ray spectrometry, and profilometry. Surface wettability was also determined based on the measurement of the OCA of water and diiodomethane. The biological responses induced in MC3T3 cells, a widely diffused osteoblast model, were correlated with the surface pattern. The unpolished samples could promote better cell viability, with a more relevant effect on the cytoskeleton arrangement as highlighted by numerous cytoplasmic extensions and filopodia-like structures and the high number of focal adhesions, while MC3T3 cells grown on polished SiN-TiN specimens displayed a flat morphology. In addition, the unpolished SiN-TiN increased osteocalcin production and calcium deposition. Taken together, these data support the biocompatibility and in vitro osteogenic properties of the electroconductive SiN-TiN investigated. Further in vivo studies are required to explore the possible use of bone implants directly obtained by EDM. [ABSTRACT FROM AUTHOR]