Chronic prosthesis-related residual limb ulcer treated with autologous micro-fragmented adipose tissue

A 56-year-old male with a past medical history significant for a left below-knee amputation and a left total knee replacement presented with knee pain at a non-healing stage 2 prosthesis-related residual limb ulcer. The ulcer at the weight-bearing surface at the anterior patella had not closed despite three years of conservative management; including offloading and wound clinic follow up. To assist with the healing process, the ulcer was treated with autologous micro-fragmented adipose tissue therapy. He was injected with 8 mLs of minimally manipulated adipose tissue (Lipogems) underneath the ulcer. Upon the four-week follow-up, his pain had resolved, and the wound was significantly reduced in size with new skin appearing. The goal of this case report is to examine if autologous micro-fragmented adipose tissue can represent a feasible and safe treatment option for chronic prosthesis-related residual limb ulcers. To our knowledge, this is the first reported case using micro-fragmented adipose therapy to treat a chronic prosthesis-related residual limb ulcer.