Background: The chondral lesion of the knee represents a challenge for the orthopedic surgeon because of the limited regenerative properties of the affected tissue. A variety of treatments has been proposed with variable success rates. Recently, new therapeutic approaches, such as the use of mesenchymal stem cells (MSCs), seem to have promising results when applied in the context of joint degeneration, and an ideal source could be the adipose tissue, due to its abundance, the easy access, and the simple isolation procedures.

Objective: To evaluate the potential benefits of injecting autologous, micro-fragmented, and minimally manipulated adipose tissue (Lipogems®) in a severe case of a multi-operated cartilage degeneration.

Case description: The patient is a 33 years-old man, semi-professional snowboarder, with a knee trauma due to a ski fall who has failed a number of treatments. The patient was injected with Lipogems® and followed up for 30 months.

Patients and Methods: Micro-fragmented adipose tissue was obtained using a minimal manipulation technique in a closed system (Lipogems®), without the addition of enzymes or any other additives.

Results: After a first period of worsening of pain, symptoms got progressively better, and the pain completely disappeared in 6 weeks. The Oxford Knee Score at 12 weeks improved from 36 (baseline) to 46. The clinical improvement was confirmed by the MRI at 12 months. Thirty months after Lipogems® treatment the patient was able to ski with no pain and no restrictions.

Conclusion: Although this is a single case report, our results suggest that the autologous, micro-fragmented and minimally manipulated adipose tissue injected in a joint affected by a chondral lesion provides support and potential healing, improves joint functionality and determines pain relief.