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Do Patient Characteristics Predict Success Following Pedal Soft Tissue Augmentation?

Marissa E. Baron, MPH; Danielle M. Minteer, Ph.D.; Beth R. Gusenoff, D.P.M.; Jeffrey A. Gusenoff, M.D.
University of Pittsburgh
2019-02-06

Presenter: Marissa E. Baron

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This project represents the original work of the student.

Director Name: Vu Nguyen, M.D.

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics

Introduction: Pedal fat grafting has been shown to improve pain and functional impairment from forefoot fat pad atrophy. We aim to determine if patient demographics and foot characteristics play a role in the level of impact that is achieved following surgery.

Methods: We performed a retrospective review of patients who received forefoot autologous fat injections for the treatment of pedal fat pad atrophy. Patient improvement of pain and functional impairment were evaluated for correlation with patient characteristics including gender, age, BMI, unilateral or bilateral injections, flexible or rigid foot arch, previous foot deformity or surgery, and presence of callus.

Results: 44 patients received fat injections into the ball of their foot. 73% of them were women, their mean age was 61 years and mean BMI was 26.6 kg/m2. 75% had injections performed bilaterally. 41% had a flexible arch, 73% had a past history of pedal deformity or surgery, and 43% had callus. Female gender was found to correlate with an improvement in pain from the time of surgery to 12 months later (p=0.02). Unilateral injections correlate with earlier improvement in functional impairment (p=0.03), and healthy BMI correlate with later improvement (p=0.01).

Conclusion: Gender, BMI, and unilateral injections correlate with the impact of pedal fat grafting surgery. Given our findings, we advocate for all patients with suspected fat pad atrophy to be considered for soft tissue augmentation. Large scale studies are called for to further elucidate the impact of various patient characteristics on the probability of success in pedal fat grafting.

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