Like most women, I’ve always thought of fat as the enemy. An omnipresent wobbly foe to be prodded, pinched and punished with diet and exercise. However, it now seems there’s an unexpected upside to those flabby bits – they might just hold the key to healing arthritis.
Harvesting your own fat and using it to repair damaged, painful joints is the intriguing premise behind Lipogems, a pioneering treatment that’s just launched in the UK at London’s Regenerative Clinic. What’s more, I’ve been one of the very first people in the country to try it.
The procedure involves sucking out tummy fat via liposuction and separating out the nice, juicy, regenerating cells it contains. After being extracted, cleansed and prepared, this healing fat is then injected directly into arthritic joints, where it’s designed to trigger a healing, anti-inflammatory, painkilling effect.
Most excitingly of all, MRI scans have shown Lipogems may have the ability to actually regrow cartilage in arthritic joints. It’s performed as a day-case procedure, can be used on arthritic knees, feet, elbows, shoulders and spines and it’s claimed it may sometimes even avoid the need for invasive joint replacement.
The surgeon’s view
It’s a hugely promising development, says orthopaedic surgeon Nima Heidari, who now offers it as an option to patients. ‘This is about harnessing the body’s natural ability to heal itself,’ he explains to me. ‘The cells that are injected into arthritic joints are like chemical factories. They sense what’s going on in areas of injury, then secrete compounds that marshal the body’s own healing response, dampen pain and calm inflammation.
‘They also release chemicals that cause cartilage cells to multiply, creating physical changes within the joint as well. For the patient, that translates into less pain and better joint function.’
If it’s exciting news to surgeons, it’s even more exciting to people such as myself who are living with arthritis. Six years ago, I underwent bunion surgery and emerged with beautifully straight big toes… and permanently painful, arthritic toe joints. (The arthritis had shown up on my x-rays before the bunion op, but I only got symptoms afterwards.)
My body compensated by subconsciously cooking up a ‘pain avoidance gait’, which meant I no longer put any weight on my big toes when I walked. While sparing me a shooting jolt of pain with each step, it goes against what the body is designed to do. It meant my hips felt unpleasantly out of joint, and I could often feel them grinding like a car that’s slipped out of gear.
By last summer, my lower back had become permanently sore, and my unbalanced ankles were aching from being repeatedly twisted over. It couldn’t be ignored any more.
Options for arthritis
It was at this point I was referred to Mr Heidari, who studied my X-rays and outlined my situation. Point one: this wouldn’t get better on its own. And point two: we were way beyond the point of orthopaedic insoles. In terms of options I could continue to suck it up, I could have foot surgery or I could look at injections. Not much fancying six weeks of downtime and crutches after an invasive operation on my toe joints, the third option certainly sounded the most appealing.
I’d already tried anti-inflammatory steroid injections in my toes, which had had had zero effect apart from making me yelp in agony. However, I was interested in the concept of Lipogems, hoping it could reduce pain and try to recushion my joints so they were no longer bone scraping against bone in places. As Mr Heidari explained, the procedure is extremely low risk, done as a day case and you simply need to take it easy for a week or so afterwards.
While it’s new to the UK, Lipogems has been already performed on over 20,000 people worldwide so far. Clinical studies are relatively small-scale but a larger double-blind, placebo-controlled trial is underway in Italy, and in one recent peer-reviewed study, 87% of patients recorded a significant reduction in pain after 12 months. Another study, which scanned knees for cartilage regrowth, found an improvement in almost all cases, with over half seeing a regrowth of 15% or more.
On the downside, it’s expensive (from £5,000), and because it has only been around a few years, Mr Heidari concedes it’s not yet known how long the benefits continue past the three-year mark currently charted. ‘We are, however, hopeful it will have a prolonged effect, unlike steroid injections which are short term.’
It should also be pointed out that while Lipogems appears to work for most people, it doesn’t work for everyone. Mr Heidari estimates around 60% have a ‘really good result’, going down two grades of arthritic severity, and 20% see a less dramatic improvement. However, the final 20% don’t respond. ‘They are probably the ones with more severe arthritis,’ he says. For that reason, anybody considering it needs to be carefully assessed by an orthopaedic surgeon for their suitability.
However there was one undeniable plus: it wasn’t burning any bridges. ‘In the best case scenario, it could mean you avoid having surgery,’ Mr Heidari explained. ‘Whatever happens, it won’t affect your treatment options for the future. But if you go for surgery now, that’s a cake you can’t unbake.’ I decided to go ahead.
Having the treatment
The most invasive part of Lipogems is the actually the liposuction element rather than the treatment of the joints. I’m sad to report the procedure doesn’t come with the side benefit of a supermodel six pack, as the amount of fat sucked out is only around 100ml – around a third of a can of Coke. (I did consider asking the cosmetic surgeon to take a little more as he marked my tummy up).
The treatment can be done under local anaesthetic but, being a confirmed wuss, I opted for light sedation. The sensation was undeniably pleasurable, rather like having a couple of G&Ts and floating off in a daydream-like haze. The video footage confirms I’m conscious and chatting, rather wild-eyed, throughout the whole thing, but I have little memory of anything once the drugs started pumping. Hallelujah to that.
The whole procedure was done within an hour. Not long after I was walking (rather gingerly) out of the clinic and into a taxi home, sporting a small bandage on each toe and a stretchy girdle to reduce the risk of bruising around my middle.
By bedtime, the local anaesthetic had worn off and I was maxed up on paracetamol to try to blunt the horrible throbbing in my toes. Thankfully this had faded to a mere ache by morning although the post-sedative ‘hangover’ had kicked in and I spent the entire day slumped, exhausted, on the sofa.
By day two, I felt sufficiently recovered to toddle to the pub around the corner for Sunday lunch. On doctor’s advice I worked from home on Monday, but by Tuesday I was back in the office.
It took around a week for my feet to feel normal again, but otherwise my recovery was quick and uncomplicated. A minority of patients get temporary flare-ups of soreness for a while afterwards but I didn’t. The two tiny puncture marks where the fat was sucked out healed up within days, and while my stomach felt a bit tender there was only a tiny trace of bruising.
But of course the big question: has it been worth it?
The results
It’s now 10 months since my op, and the results are remarkable. The biggest difference is in my right foot. Within a few weeks, the pain was already dramatically reduced, and now my big toe feels nearly normal again. I have to really bend it to feel a dull arthritic grumble.
My left foot hasn’t been quite as successful, but there is still a big difference overall. I only get a sharp wince of arthritis if I’m putting the joint under a lot of stress, like trying to do a one-legged lunge, and even then the pain is far less than it was before. I can live with that.
Mr Heidari is pleased with my progress. My x-rays look the same – the arthritis hasn’t magically vanished – but the symptoms have dramatically reduced. I now have a ‘normal gait’ and I’m bearing weight on my big toes again.
Arthritis has gone from something that nagged and depressed me every day to something I rarely think about. My body feels aligned again. I can wear heels without jolts of pain or twisting my ankles, my hips don’t crunch when I walk, and my back no longer aches. I just hope the benefits continue and I can keep surgery at bay. Fingers and toes crossed…
Lipogems is available in the UK exclusively in the UK at The Regenerative Clinic, starting from £5,000. Call 0330 223 3332 or see www.theregenerativeclinic.co.uk
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