Abstract
Background: Musculoskeletal (MSK) ultrasound is increasingly used for point-of-care diagnosis, delivery of therapeutics like orthobiologics, and follow-up evaluations. However, it is underutilized for the harvest of orthobiologic tissue such as adipose, leading to concerns about safety and procedure accuracy. Adipose tissue is a valuable orthobiologic source due to its regenerative potential, high progenitor cell content, and resistance to age-related decline. Safe, targeted harvesting is critical to maintain graft integrity.
Objective: To describe and validate a novel, ultrasound-guided manual lipoaspiration technique for precise and safe harvest of abdominal adipose tissue for orthobiologic use.
Methods: High-frequency (4–13 MHz) interventional ultrasound was used to identify the mantle and deep layers of the anterior abdominal subcutaneous compartment in three cadaveric models. Manual lipoaspiration was performed using a blunt-tip cannula under real-time ultrasound guidance. Procedural validation included colored latex injections to the harvest sites to assess for anatomical accuracy, as well as dissection and microscopic evaluation of the aspirated tissue to confirm adipose identity.
Results: All six aspiration sites yielded adipose tissue without evidence of muscle or peritoneal involvement. Microscopy revealed classic adipocyte morphology, and density centrifugation confirmed low-density tissue, consistent with adipose. Colored latex remained confined to the intended adipose compartments on dissection, confirming harvest precision.
Conclusion: This cadaveric study demonstrates that manual lipoaspiration performed under ultrasound guidance allows for safe and anatomically accurate adipose harvesting, preserving adjacent structures and tissue integrity. MSK ultrasound supports a full orthobiologic workflow—from harvest to injection and post-treatment monitoring—enhancing procedural safety, biologic effectiveness, and standardization in regenerative care. Further clinical research is needed to assess graft viability and therapeutic outcomes in live patients.