Where to See Dr. Tortland in Connecticut
Dr. Paul Tortland, DO provides comprehensive orthopedic evaluations for patients at his Glastonbury, CT office. The practice sees patients from Glastonbury, Hartford, West Hartford, Farmington, Simsbury, South Windsor, and other Connecticut and New England communities.
📍 59 Sycamore Street, Suite 301, Glastonbury, CT 06033 — Get directions
📞 (860) 430-2821
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Direct answer: Microfragmented adipose tissue (MFAT) therapy uses a small amount of your own fat, usually from the abdomen or flank, that is mechanically processed (not enzymatically digested) and injected the same day under image guidance, most often for knee osteoarthritis. Randomized trials show meaningful pain relief compared with saline, but MFAT has not been proven better than PRP, and it does not regrow cartilage.
What MFAT Is
Fat tissue contains a supportive network of cells, including stromal and vascular cells, embedded in a natural structural matrix. MFAT breaks harvested fat into small clusters by purely mechanical means. That approach keeps the tissue's architecture and cell mix largely intact, rather than isolating individual cells with enzymes.
That processing detail matters. It is one reason MFAT is regulated differently from enzymatically processed fat products, and it is why research on one type of fat-derived injection cannot simply be applied to another.
Like bone marrow aspirate concentrate (BMAC), MFAT is autologous, meaning it comes from you and goes back to you during the same visit. It is fundamentally different from commercial donor-tissue products marketed as "stem cells."
How the Procedure Works
- Evaluation first. Candidacy is decided during an unrushed initial visit of at least an hour, which includes a live musculoskeletal ultrasound exam.
- Harvest. After local anesthetic, a small volume of fat is collected through a narrow cannula, typically from the abdomen or flank.
- Processing. The fat is washed and mechanically microfragmented on site.
- Injection. Dr. Tortland personally injects the graft under image guidance into the target joint or tissue.
- Time. Plan on 2 to 3 hours for the entire visit. Soreness and bruising at the harvest site for several days are common.
For arthritis, a cellular procedure is often followed by a PRP procedure roughly 4 to 6 weeks later as part of the overall plan.
Who May Be a Candidate
- Adults with mild to moderate knee osteoarthritis who still have meaningful joint space
- Patients who have tried structured rehabilitation and activity changes without enough relief
- Patients whose benefit from corticosteroid or PRP injections was limited or short-lived
- Patients seeking a non-surgical option who understand the limits described below
In our practice, patients referred for MFAT evaluation often arrive after a corticosteroid or PRP injection that helped for a while but didn't last, a pattern consistent with what the trials below describe. MFAT is generally not a good fit for end-stage arthritis with deformity or instability, or for patients with very little harvestable fat. Some medical conditions and medications also affect whether a harvest is appropriate.
What the Current Evidence Shows
- Randomized controlled trial (Richter et al., 2025). Seventy-five patients with knee osteoarthritis received MFAT, a corticosteroid, or saline. MFAT produced statistically and clinically significant pain and function improvements compared with saline that held through one year. The corticosteroid group beat saline only at 2 and 6 weeks.
- Randomized controlled trial (Zaffagnini et al., 2022). In 118 patients, a single MFAT injection was not superior to a single PRP injection. Both groups improved through two years, and imaging showed no structural change in either group. In a secondary analysis, more patients with moderate to severe arthritis reached a clinically meaningful improvement with MFAT at 6 months, a finding that needs confirmation.
- Systematic review (Hohmann et al., 2025). Across 21 studies, MFAT improved pain and function scores at 6 and 12 months, with moderate-quality evidence. The authors advise interpreting the results with caution.
- Related large trial (Mautner et al., 2023). An enzymatically processed fat product (stromal vascular fraction) was not superior to corticosteroid at one year. Because that product is processed differently from MFAT, the results are related but not directly interchangeable.
The balanced takeaway is that MFAT appears safe and can provide lasting pain relief for well-selected patients. Its advantage over PRP remains unproven, and there is no evidence that it rebuilds cartilage.
How MFAT Compares With BMAC
Both are same-day, autologous cellular orthobiologics. They differ in tissue source, harvest site, and cell composition. Neither has been proven clearly superior to the other. The choice depends on the diagnosis, the patient's anatomy and health history, prior treatment response, and the physician's assessment. Read more in BMAC Explained.
When Non-Surgical Care May Be Appropriate
For mild to moderate knee arthritis, a comprehensive non-surgical plan is often a sensible first step. That plan typically includes strengthening, weight management where relevant, activity modification, and, when the evaluation supports it, an orthobiologic such as PRP or MFAT.
When Surgery May Be More Appropriate
Joint replacement or other surgery is usually the better answer for bone-on-bone arthritis with deformity, significant mechanical symptoms or instability, or severe pain and disability despite a genuine trial of non-surgical care. When that is the case, Dr. Tortland says so and refers patients to trusted orthopedic surgeons.
What MFAT Does Not Do
- It does not regenerate lost cartilage or reverse structural joint damage.
- It has not been proven superior to PRP.
- It is not a substitute for joint replacement when replacement is genuinely the better option.
- It does not guarantee results. Benefit varies and is not necessarily permanent.
- It is a more involved procedure than a standard injection, with a harvest site that needs a few days to recover.
Dr. Tortland's Perspective
Patients often ask whether MFAT is "stronger" than PRP. The honest answer is that the best trial we have did not show that, even though some patients with more advanced arthritis may do especially well with it. I recommend MFAT when the exam, the ultrasound, and the patient's history point toward it, and I explain the evidence, including its limits, before anyone commits. If surgery is the better answer, I will say so.
Related Questions
- What is BMAC, and how is it different?
- Can any injection regrow cartilage?
- What are my non-surgical options for knee arthritis?
- How are autologous treatments different from commercial "stem cell" products?
Next Step
Learn more on the Cellular Orthobiologics page, or schedule a consultation for a thorough evaluation, including a live ultrasound exam, and an honest discussion of whether MFAT, another option, or surgery fits your situation.
