<< Back to the abstract archive
Fat Grafting for Fat Pad Atrophy of the Heel: A Randomized Controlled Trial
James IB, Gusenoff BR, Wang S, DiBernardo G, Minteer DM, Gusenoff JA
University of Pittsburgh Department of Plastic Surgery
2018-02-14
Presenter: Isaac B James
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.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
BACKGROUND: The shock absorbing soft tissues of the heel are composed of dermis and two specialized fat pads-a thin, superficial microchamber (MIC), and a thicker, deep macrochamber (MAC). Atrophy of these soft tissues is common and can be painful and debilitating. However, current treatment is limited to offloading with orthotics and padding. This randomized, controlled trial investigates the use of autologous fat grafting to treat symptomatic fat pad atrophy of the heel.
METHODS: Fat was harvested from the abdomen using manual liposuction then processed and injected by Coleman technique into the MAC of 7 patients (11 feet) with an average volume of 6.9cc grafted per heel. Patients were offloaded for 4wks post-operatively using a customized Darco shoe. Ultrasound-measured tissue thickness and Manchester Foot Pain and Disability Index (MFPDI) were obtained pre-operatively and followed for 1 year post-operatively. Outcomes were compared against 5 randomly selected control patients who received standard-of-care offloading only.
RESULTS: Average age was 56. Average BMI was 30. 50% of patients were female. No patients were active smokers or diabetic. Compared to controls, subjects receiving fat grafting had significantly greater MAC fat pad thickness at 6 and 12 months (p<0.05) and significantly improved foot pain (p=0.015) and foot appearance (p=0.048) scores by 6 months. Interestingly, fat grafting also increased dermal thickness at 12 months (p=0.01).
CONCLUSIONS: Our data suggest that fat grafting can improve foot function in patients with heel fat pad atrophy by preserving shock absorbing soft tissue and reducing pain.
