Autologous Fat Grafting as a Last Resort for Unsustainable Pain in a Woman with Multiple Osteochondromas

Multiple osteochondromas (MO) is characterized by the formation of osteochondromas throughout the entire body. Although the evidence regarding its pathogenesis is well understood, no curative treatment for the disorder is available. Patients can be treated symptomatically by surgical removal of painful osteochondromas. Unfortunately, some patients still suffer from severe pain, even after surgery. We report on a case concerning a 48-year-old woman with a history of MO who presented with persistent pain after surgical removal of a symptomatic osteochondroma of the left scapula and multiple symptomatic osteochondromas of the left foot and trochanteric region. Several interventions to reduce the pain did not have any lasting effect. Subsequently, she was treated with autologous fat grafting (AFG). After each session she was pain-free for at least one year and reported only partial recurrence of the pain. This is the first case report describing AFG for the treatment of pain after both surgical removal of an osteochondroma and symptomatic osteochondromas in a patient suffering MO with promising results. The treatment is more effective and clearly continues to remain active longer than injection therapy or pain medication. Future studies are necessary to confirm our results.

Keywords

Multiple hereditary exostoses - Adipose tissue - Pain management

We would like to acknowledge Dr. M.H. Haloua for helping us with selecting the radiological images.

Publikationsverlauf

Eingereicht: 31. März 2016

Angenommen: 17. August 2016

Artikel online veröffentlicht:
20. April 2022

• REFERENCES

• 1 Ham SJ, de Lange J, van der Zwan AL. et al. Clinical problems in multiple osteochondroma. Ned Tijdschr Geneeskd 2012; 156: A4254
• 2 Stieber JR, Dormans JP. Manifestations of hereditary multiple exostoses. J Am Acad Orthop Surg 2005; 13: 110-120
• 3 Darilek S, Wicklund C, Novy D. et al. Hereditary multiple exostosis and pain. J Pediatr Orthop 2005; 25: 369-376
• 4 Ryckx A, Somers JF, Allaert L. Hereditary multiple exostosis. Acta Orthop Belg 2013; 79: 597-607
• 5 Darilek S, Wicklund C, Novy D. et al. Hereditary Multiple Exostosis and Pain. J Pediatr Orthop 2006; 25: 369-376
• 6 Baptista C, Iniesta A, Nguyen P. et al. Autologous fat grafting in the surgical management of painful scar: preliminary results. Chir Main 2013; 32: 329-334
• 7 Caviggioli F, Maione L, Forcellini D. et al. Autologous fat graft in postmastectomy pain syndrome. Plast Reconstr Surg 2011; 128: 349-352
• 8 Klinger M, Caviggioli F, Klinger FM. et al. Autologous fat graft in scar treatment. J Craniofac Surg 2013; 24: 1610-1615
• 9 Solomon L. Bone growth in diaphysial aclasis. J Bone Joint Surg Br 1961; 43: 700-716
• 10 Porter DE, Lonie L, Fraser M. et al. Severity of disease and risk of malignant change in hereditary multiple exostoses: a genotype-phenotype study. J Bone Joint Surg Br 2004; 86: 1041-1046
• 11 Bovee JV. Multiple osteochondromas. Orphanet J Rare Dis 2008; 3: 3
• 12 Sonne-Holm E, Wong C, Sonne-Holm S. Multiple cartilaginous exostoses and development of chondrosarcomas: a systematic review. Dan Med J 2014; 61: A4895
• 13 Goud AL, de Lange J, Scholtes VA. et al. Pain, physical and social functioning, and quality of life in individuals with multiple hereditary exostoses in The Netherlands: a national cohort study. J Bone Joint Surg (Am) 2012; 94: 1013-1020
• 14 Negenborn VL, Groen JW, Smit JM. et al. The Use of Autologous Fat Grafting for Treatment of Scar Tissue and Scar-Related Conditions: A Systematic Review. Plast Reconstr Surg 2016; 137: 31e-43e
• 15 Zhou Y, Wang J, Li H. et al. Efficacy and Safety of Cell-Assisted Lipotransfer: A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2016; 137: 44e-57e