title: Autologous Fat Grafting as a Last Resort for Unsustainable Pain in a Woman with Multiple Osteochondromas.
abstract: 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.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouwe Gasthuis Oost, Amsterdam, The Netherlands.
authors.forename: Vera Lidwina
authors.initials: VL
authors.lastname: Negenborn
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouwe Gasthuis Oost, Amsterdam, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Moerman
authors.affiliation: MO-Expertise Center, Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis Oost, Amsterdam, The Netherlands.
authors.forename: Simon Johannes
authors.initials: SJ
authors.lastname: Ham
keywords: Adipose tissue; Multiple hereditary exostoses; Pain management