Management of Advanced Tricompartmental Knee Osteoarthritis With Degenerative Meniscal Pathology Using Extracorporeal Magnetotransduction Therapy, Extracorporeal Shockwave Therapy, Microfragmented Adipose Tissue, and Platelet-Rich Plasma

Advanced tricompartmental knee osteoarthritis (OA) with degenerative meniscal tears and ligamentous insufficiency represents a considerably difficult presentation in non-surgical musculoskeletal medicine.Although total knee arthroplasty is the current standard for surgical intervention, many patients may prefer to first explore non-surgical options or may require interim symptom management prior to surgery.This report describes management of a complex case of advanced knee OA via a staged non-surgical protocol utilizing extracorporeal shockwave therapy (ESWT), extracorporeal magnetotransduction therapy (EMTT), and a combined microfragmented adipose tissue (MFAT) and platelet-rich plasma (PRP) procedure in a 68year-old female.The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Numeric Rating Scale (NRS) were used to track patient progress and pain throughout treatment and post-procedure follow-ups.The KOOS is a patient-reported outcome measure consisting of five subscales in its entirety: pain, symptoms, activities of daily living, recreation function, and quality of life (QOL).For the purposes of tracking our outcomes in this specific case, we determined that only the pain, symptoms, and QOL subscales were relevant to the real-world outcomes of this patient.The NRS is an 11-point patient-reported pain scale ranging from 0 to 10.The patient showed a reduction in NRS pain scores and overall improvement in KOOS domains of pain, symptoms, and QOL.Biologic joint preservation using MFAT and PRP with mechanotransductive priming produced clinically meaningful improvement in advanced knee OA, warranting consideration as a bridge or alternative to arthroplasty in appropriate patients.