Adipose- derived stromal cells procedure
hematoma
STERILE, HEMATOMA, INFILTRATED
Patients were placed supine; the abdomen was prepared in a standard fashion with betadine and chlorhexidine. The surgical field was prepared, and 5 ml of Lidocaine 2% was injected at the site of skin incision. All procedures were performed by two fully trained surgeons (DN and AZ) using the Tulip Soft Harvest GOLD System (Tulip Medical) (Fig. Tulip Soft Harvest GOLD Kit (Tulip Medical)The harvesting area is the abdominal subcutaneous adipose tissue. After performing a small skin incision, a harvesting cannula connected to a 60 ml syringe was used to inject homogenously (Fig. Inject anaesthetic solutionThe distribution of 60 ml of the solution in the subcutaneous layers is facilitated by digital manipulation of the abdomen. After 5 min, a harvesting cannula connected to a self-blocking 20 ml syringe is introduced in the subcutaneous fat, and lipoaspiration can start. The block system produces negative pressure inside the syringe, allowing to harvest the lipoaspirate from the previously infiltrated areas (Fig. LipoaspirationAfter obtaining the lipoaspirate, 10 ml of tranexamic acid is injected (Fig. Tranexamic acid injectionThe fat-containing syringe was sequentially passed 30 times through a 2.4 mm, 1.4 mm, and 1.2 mm Luer-to-Luer transfer device connected to another empty 20 ml syringe (Fig. Filtration through transfer devicesPre-emulsified lipoaspirate was then collected in a sterile NanoTransfer device and transferred by a single pass through a 0.6- to 0.4 mm mesh screen into an empty 10 ml syringe, ready for injection (10 ml) intra-articularly (Fig. NanoTransfer deviceThe choice of injection portal may be either superolateral under the patella with the knee extended or through the inferomedial or inferolateral soft part of the knee with the knee flexed to 90° (Fig. Anterolateral injectionAfter the injection, the knee is flexed and extended to diffuse the product in the joint. At discharge, all patients were instructed to wear an elastic dressing for a week to reduce the occurrence of hematoma on the abdomen. Patients are partial weight bearing with crutches, and full unaided weight bearing on the treated knee is allowed after 1 week. All patients were instructed to perform isometric quadriceps exercises, and started physiotherapy after 1 week.