Biofat grafts as an orthobiologic tool in osteoarthritis:An update and classification proposal

摘要

Among degenerative musculoskeletal disorders,osteoarthritis remains one of the main causes of pain and disability in the adult population.Current available alternatives to alleviate symptoms include conservative treatments such as physical therapy,anti-inflammatory drugs and an educational approach to lifestyle modification.The use of certain analgesics,such as opiates and corticosteroids offer short-term results but does not address the etiological source of pain and disability.In addition,prolonged use of such medications can cause additional complications.Therefore,the demand for regeneration of joint cartilage has led to an alternative approach called"orthobiologics".This alternative is based on cellular and molecular components capable of inducing and promoting tissue repair.Products derived from adipose tissue have been studied as an excellent source of orthobiologics in an attempt to promote joint cartilage repair.However,the lack of standardization regarding collection and processing protocols presents a challenge for the generalization of study results and determination of effectiveness.To the best of our knowledge,orthobiologics derived from fat have not yet been classified.Therefore,this manuscript proposes the HGS classification system which aims to describe certain parameters that are relevant to the quality of organic products regarding harvesting techniques(H),graft type(G),and number of centrifugations(S).The more parameters used would imply greater characterization and complexity of the evaluation of the biological product used.The HGS classification may provide a valuable contribution to the understanding of clinical procedures and research results,aiming to ultimately usher in a standardization of optimal practice.