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Physical Medicine and Rehabilitation Clinics of North America

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https://www.readbyqxmd.com/read/27788911/maybe-there-is-an-alternative-treatment-option
#1
EDITORIAL
Santos F Martinez
No abstract text is available yet for this article.
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788910/orthobiologics-and-knee-osteoarthritis-a-recent-literature-review-treatment-algorithm-and-pathophysiology-discussion
#2
REVIEW
David M Crane, Kristin S Oliver, Matthew C Bayes
This article reviews the current options in orthobiologics for the clinical treatment of knee osteoarthritis (OA). We describe a new model of knee OA that fills the gap in our understanding of it as a purely traumatic and/or inflammation-induced cartilage degenerative condition, to a current model of multinodal pathophysiology. We discuss graft choice and patient selection in the current state of understanding of the treatment of knee OA in a tissue engineering model with orthobiologics. We present a sample treatment algorithm and decision nest for deciding how to proceed with patient care...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788909/regenerative-approaches-to-tendon-and-ligament-conditions
#3
REVIEW
Michael N Brown, Brian J Shiple, Michael Scarpone
Tendon and ligament injuries and degenerative conditions of these soft tissues have poor healing potential and healing is often incomplete. Biocellular and orthobiologic approaches including PRP and stem cell therapies are reviewed. A review of some of the regenerative medicine science and difficulties facing physicians exploring these methods is presented. A series of cases are reviewed demonstrating the application of these principles. Clinical experience with many of these biocellular interventions is outpacing validation in basic science studies...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788908/performing-a-better-bone-marrow-aspiration
#4
REVIEW
Mayo F Friedlis, Christopher J Centeno
Bone marrow aspiration (BMA) is increasingly being used to harvest stem cells for use in regenerative medicine. The focus of BMA in interventional orthopedics is to maximize the yield of mesenchymal stem cells. The authors present an improved method for BMA that involves fluoroscope or ultrasound guidance combined with anesthesia; in the authors' experience, it produces the highest possible stem cell yield and is well tolerated by patients. The authors provide a step-by-step guide to the process, along with a discussion of technical and other considerations and quick reference guides for ultrasound- and fluoroscope-guided BMA...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788907/%C3%AE-2-macroglobulin-autologous-protease-inhibition-technology
#5
REVIEW
Jason M Cuéllar, Vanessa Gabrovsky Cuéllar, Gaetano J Scuderi
α2-Macroglobulin (A2M) is a plasma glycoprotein best known for its ability to inhibit a broad spectrum of serine, threonine, and metalloproteases as well as inflammatory cytokines by a unique bait-and-trap method. A2M has emerged as a unique potential treatment of cartilage-based pathology and inflammatory arthritides. This article describes the unique method by which A2M not only inhibits the associated inflammatory cascade but also disrupts the catabolic process of cartilage degeneration. Autologous concentrated A2M from plasma is currently in use to successfully treat various painful arthritides...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788906/autologous-conditioned-serum
#6
REVIEW
Christopher H Evans, Xavier Chevalier, Peter Wehling
Autologous conditioned serum was developed in the mid 1990s as an expeditious, practical, and relatively inexpensive means of generating the interleukin-1 receptor antagonist, a naturally occurring inhibitor of the cytokine interleukin-1. The latter is thought to be an important mediator of inflammation, pain, and tissue destruction in musculoskeletal conditions. ACS has been widely and successfully used in the local treatment of human and equine osteoarthritis and radicular compression; it has also shown promise in treating tendinopathies, muscle injuries, and tunnel widening after reconstruction of the anterior cruciate ligament...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788905/biocellular-regenerative-medicine-use-of-adipose-derived-stem-stromal-cells-and-it-s-native-bioactive-matrix
#7
REVIEW
Robert W Alexander
"Using your own tissues to heal" represents a major health care paradigm change and is one of the most exciting minimally invasive options currently available. Biocellular regenerative therapies are rapidly improving in documentation and cellular analyses and are gaining good safety and efficacy profiles. Once considered purely experimental, they have entered into an accepted, translational period to clinical providers, backed by improving science supporting the basic hypotheses. It is a well-recognized and reported alternative to many traditional medical/surgical interventions...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788904/stem-cell-considerations-for-the-clinician
#8
REVIEW
Karen A Hasty, Hongsik Cho
"Although there is ample evidence that beneficial results can be obtained from the use of mesenchymal stem cells, several questions regarding their use remain to be answered. For many of these questions, preclinical models will be helpful, but the task of evaluating and implementing these findings for orthopaedic patients falls onto the shoulders of clinical researchers. Evaluation of these questions is a daunting, but such a challenge fits the concept of personalized medicine in today's medicine."
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788903/platelet-rich-plasma
#9
REVIEW
Peter I-Kung Wu, Robert Diaz, Joanne Borg-Stein
Platelet-rich plasma (PRP) is a growing and robust therapeutic option in musculoskeletal medicine. PRP is a preparation of autologous plasma enriched with a platelet concentration above that normally contained in whole blood. The rationale for use and therapeutic potential of a high concentration of platelets is based on their capacity to supply supraphysiologic amounts of essential growth factors to provide a regenerative stimulus that promotes repair in tissues with low healing potential. This article reviews the latest basic science on PRP, clinical evidence for its use in musculoskeletal medicine, limitations in current knowledge, and critical areas for future research...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788902/dextrose-prolotherapy-a-narrative-review-of-basic-science-clinical-research-and-best-treatment-recommendations
#10
REVIEW
Kenneth Dean Reeves, Regina W S Sit, David P Rabago
Prolotherapy involves the injection of nonbiologic solutions, typically at soft tissue attachments and within joint spaces, to reduce pain and improve function in painful musculoskeletal conditions. A variety of solutions have been used; dextrose prolotherapy is the most rigorously studied and is the focus of this review. Although the mechanism of action is not clearly known, it is likely to be multifactorial. Data on effectiveness for temporomandibular dysfunction are promising but insufficient for recommendations...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788901/the-healing-cascade-facilitating-and-optimizing-the-system
#11
REVIEW
Ethan Rand, Alfred C Gellhorn
Healing is a complex process of orchestrated reactions and interactions with the goal of restoring structure and physical properties to damaged tissues. The musculoskeletal system is composed of different types of connective tissues. When healthy, each has a unique structure, function, and remodeling process. When damaged, they demonstrate unique healing processes. However, similarities in the process exist. Understanding these properties of healing is critical in the development and application of regenerative therapeutics...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788900/rehabilitation-considerations-in-regenerative-medicine
#12
REVIEW
Penny L Head
Rehabilitation and regenerative medicine therapies has shown improved outcomes for tissue regeneration. Regenerative rehabilitation guides protocols regarding when to start therapy, types of stimuli administered, and graded exercise programs, taking into account biological factors and technologies designed to optimize healing potential. Although there are currently no evidence-based guidelines for rehabilitation, fundamental physical therapy principles likely apply. Immobilization tends to have deleterious effects on musculoskeletal tissues; mechanical loading promotes tissue healing and regeneration...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788899/orthopedic-surgical-options-for-joint-cartilage-repair-and-restoration
#13
REVIEW
David J Ruta, Arturo D Villarreal, David R Richardson
The limited natural capacity for articular cartilage to regenerate has led to a continuously broadening array of surgical interventions. Used once patients' symptoms are not relieved by nonoperative management, these share the goals of joint preservation and restoration. Techniques include bone marrow stimulation, whole-tissue transplantation, and cell-based strategies, each with its own variations. Many of these interventions are performed arthroscopically or with extended-portal techniques. Indications, operative techniques, unique benefits, and limitations are presented...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788898/regenerative-treatments-for-spinal-conditions
#14
REVIEW
Angelie Mascarinas, Julian Harrison, Kwadwo Boachie-Adjei, Gregory Lutz
A literature review of clinical and translational studies was performed to provide an overview of current concepts on regenerative treatments for spinal conditions, including platelet rich plasma and stem cell treatments to treat low back pain.
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27468678/outpatient-ultrasound-guided-musculoskeletal-techniques
#15
EDITORIAL
Evan Peck
No abstract text is available yet for this article.
August 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27468677/a-new-interventional-field
#16
EDITORIAL
Santos F Martinez
No abstract text is available yet for this article.
August 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27468676/past-present-and-future-considerations-for-musculoskeletal-ultrasound
#17
REVIEW
Scott J Primack
Musculoskeletal ultrasound has a rich history originally rooted in nautical technology. In recent years, it has proliferated significantly for both diagnostic and interventional purposes in the point-of-care clinical setting by nonradiologist musculoskeletal clinicians. This article outlines the history of musculoskeletal ultrasound, examines present developments, and discusses its future outlook.
August 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27468675/advanced-ultrasound-guided-interventions-for-tendinopathy
#18
REVIEW
Evan Peck, Elena Jelsing, Kentaro Onishi
Tendinopathy is increasingly recognized as an important cause of musculoskeletal pain and disability. Tendinopathy is thought to be principally a degenerative process, rather than inflammatory as was traditionally believed. Consequently, traditional tendinopathy treatments focused solely on decreasing inflammation have often been ineffective or even harmful. The advancement of ultrasonography as for guidance of outpatient musculoskeletal procedures has facilitated the development of novel percutaneous procedures for the treatment of tendinopathy, mostly by using mechanical intervention to stimulate regeneration...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27468674/orthobiologic-interventions-using-ultrasound-guidance
#19
REVIEW
Gerard Malanga, Dena Abdelshahed, Prathap Jayaram
The application of regenerative therapies for the treatment of musculoskeletal conditions has emerged over the last decade with recent acceleration. These include prolotherapy, platelet-rich plasma, and mesenchymal stem cell therapy. These strategies augment the body's innate physiology to heal pathologic processes. This article presents an overview of platelet-rich plasma and mesenchymal stem cell therapy for the treatment of musculoskeletal injuries. A brief literature review is included, as are techniques for the use of ultrasound guidance to assist with these procedures...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27468673/ultrasound-guided-peripheral-nerve-procedures
#20
REVIEW
Jeffrey A Strakowski
Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
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