patient who needs wrist surgery holding their wrist

One of the most frequent disorders we see is arthritis of the wrists. The degenerative lesions of the cartilage in this chronic, non-inflammatory joint disease causes severe functional impairment, including pain, weakness, and loss of range of motion. Hand surgeons resort to surgical fusion only when less invasive options fail. Fortunately, adipose derived stem cell injection (ADSC) can provide an effective alternative to wrist fusion surgery.

Two factors contributing to its rising incidence are:

  1. Our aging population
  2. Catastrophic injuries sustained playing sports

Most post-traumatic OA results from scapholunate ligament tears that cause arthritis of the joints of the wrist, and carpal disorganization (also known as scapholunate advanced collapse, or SLAC). If treated early with ultrasound guided PRP injection, wrist arthritis can be prevented. Bone trauma can lead to what is called sequelae of scaphoid nonunion advanced collapse (also known as SNAC). These common injuries often lead to hand surgery when wrist pain becomes intolerable.

Radiographs of typical wrist fusion surgery

At Oregon Regenerative Medicine, the use of orthobiologic injection therapy based on adipose derived stem cells (ADSC) plus PRP has provided excellent benefit in the treatment of wrist arthritis and pain. The combination of microfat (MF) and platelets-rich plasma (PRP), which is rich in growth factors and adipose stem cells, has been an effective, injectable option for the minimally invasive treatment of wrist osteoarthritis, and avoiding wrist fusion surgery.

Wrist fusion surgery alternative and wrist joint preservation

In this recent study, the clinical outcomes from three patients’ treatments at 12 months were summarized. According to approved methodologies, the biological characterisation of microfat, PRP, and combination was examined in vitro. Treatment was given to patients who had (the most advanced OA (stage 4 OA, Kellgren Lawrence classification) who had not responded to conservative treatment, and  who had persistent daily pain that measured >40 mm on the visual analogue scale (VAS). 

Pain relief and functional improvement by more than 50% was seen in all three patients after one year

Pain relief and functional improvement was seen in all three patients after one year with DASH and PRWE functional scores achieving minimal clinically meaningful differences and pain decreasing by more than 50% (per VAS score).

xrays of pre and post wrist stem cell injections
MRI: Pre-stem cell injection (left) and 12-months post-stem cell injection (right) shows new cartilage formation in joint space.  Adapted from Alice Mayol, Department of Hand and Limb Reconstructive Surgery, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France

The combination of microfat and PRP enhances the trophic and regenerative effects on injured cartilage

In terms of the mechanism of action, the combination of microfat and PRP enhances the trophic and regenerative effects on the locations of injured cartilage. Theoretically, the combination of these two products, which are each rich in autologous multipotent stem cells and growth factors, intends to produce the ideal conditions for the regeneration of cartilage cells. Additionally, microfat might act as a scaffold to prevent PRP from resorbing.

If you have osteoarthritis and pain of the wrists, and want to avoid surgery, consult with the experts in wrist joint preservation at Oregon Regenerative Medicine. The earlier you get treated, the better the results.


  1. Wrist osteoarthritis,a review Orthop Traumatol Surg Res; 2015 Feb;101(1 Suppl):S1-9.doi: 10.1016/j.otsr.2014.06.025. Epub 2015 Jan 14
  2. Development of Autologous Platelet-Rich Plasma Mixed-Microfat as an Advanced Therapy Medicinal Product for Intra-Articular Injection of Radio-Carpal Osteoarthritis: From Validation Data to Preliminary Clinical Results, Int J Mol Sci. 2019 Mar; 20(5): 1111

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