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Nicolas S Piuzzi, Zaamin B Hussain, Jorge Chahla, Mark E Cinque, Gilbert Moatshe, Venkata P Mantripragada, George F Muschler, Robert F LaPrade
BACKGROUND: Interest in the therapeutic potential of bone marrow aspirate concentrate (BMAC) has grown exponentially. However, comparisons among studies and their processing methods are challenging because of inconsistent reporting of protocols, as well as poor characterization of the composition of the initial bone marrow aspirate and of the final products delivered. The purpose of this study was to perform a systematic review of the literature to evaluate the level of reporting related to the protocols used for BMAC preparation and the composition of BMAC utilized in the treatment of musculoskeletal diseases in published clinical studies...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Jolanta Sroka, Eliza Zimolag, Slawomir Lasota, Wlodzimierz Korohoda, Zbigniew Madeja
Electrotaxis plays an important role during embryogenesis, inflammation, wound healing, and tumour metastasis. However, the mechanisms at play during electrotaxis are still poorly understood. Therefore intensive studies on signaling pathways involved in this phenomenon should be carried out. In this chapter, we described an experimental system for studying electrotaxis of Amoeba proteus, mouse embryonic fibroblasts (MEF), Walker carcinosarcoma cells WC256, and bone marrow adherent cells (BMAC).
2018: Methods in Molecular Biology
Iain R Murray, Patrick G Robinson, Christopher C West, Ewan B Goudie, Li Y Yong, Timothy O White, Robert F LaPrade
PURPOSE: To perform a systematic review of clinical studies evaluating bone marrow aspirate concentrate (BMAC) in the treatment of musculoskeletal pathology to compare levels of reporting with recently published minimum standards. METHODS: A systematic review of the clinical literature from August 2002 to August 2017 was performed. Human clinical studies published in English and involving the administration of BMAC for musculoskeletal applications were included...
January 22, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Elisabeth R Garwood, Christopher J Burke, Laith M Jazrawi, Ronald S Adler
Emerging musculoskeletal applications for local administration of autologous bone marrow aspirate concentrate (BMAC) include treatment of fractures, osteonecrosis, osteochondral injuries, osteoarthritis, ligament injury, tendon injury, and tendonopathies. Ultrasound-guided technique for various BMAC injection sites is detailed in this technical report and our preliminary clinical experience outlined.Five patients, 1 woman and 4 men, were treated with 6 peri/intratendinous (n = 4) or intraarticular (n = 2) BMAC injections between July 5, 2015 and December 31, 2016 for the clinical indications of common hamstrings origin tendinosis (n = 4), hip labral tear (n = 1), and osteochondral lesion of the talus (n = 1)...
January 23, 2018: Ultrasound Quarterly
Sydney C Karnovsky, Bridget DeSandis, Amgad M Haleem, Carolyn M Sofka, Martin O'Malley, Mark C Drakos
BACKGROUND: The purpose of this study was to compare the functional and radiographic outcomes of patients who received juvenile allogenic chondrocyte implantation with autologous bone marrow aspirate (JACI-BMAC) for treatment of talar osteochondral lesions with those of patients who underwent microfracture (MF). METHODS: A total of 30 patients who underwent MF and 20 who received DeNovo NT for JACI-BMAC treatment between 2006 and 2014 were included. Additionally, 17 MF patients received supplemental BMAC treatment...
January 1, 2018: Foot & Ankle International
James W Bellew, Molly Allen, Austin Biefnes, Sara Grantham, James Miglin, Dylan Swartzell
OBJECTIVE: Efficacy of neuromuscular electrical stimulation (NMES) is limited by the discomfort of electrically elicited contractions. Most studies of tolerance to NMES have examined stimulation to maximal tolerance. NMES efficiency is the amount of elicited force at a specific level of tolerance. This study is the first to describe and examine such. DESIGN: A repeated measures design was used. Electrically elicited force (EEF) was measured using three waveforms: burst-modulated alternating current (BMAC), pulsed current (PC), and burst-modulated pulsed current (BMPC)...
January 8, 2018: Physiotherapy Theory and Practice
Bridget A DeSandis, Amgad M Haleem, Carolyn M Sofka, Martin J O'Malley, Mark C Drakos
Juvenile allogenic chondrocyte implantation (JACI; DeNovo NT Natural Tissue Graft®; Zimmer, Warsaw, IN) with autologous bone marrow aspirate concentrate (BMAC) is a relatively new all-arthroscopic procedure for treating critical-size osteochondral lesions (OCLs) of the talus. Few studies have investigated the clinical and radiographic outcomes of this procedure. We collected the clinical and radiographic outcomes of patients who had undergone JACI-BMAC for talar OCLs to assess treatment efficacy and cartilage repair tissue quality using magnetic resonance imaging (MRI)...
January 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sang Jun Kim, Eun Kyung Kim, Sun Jeong Kim, Da Hyun Song
BACKGROUND: We compared the clinical course of rotator cuff tears between rotator cuff exercise and bone marrow aspirate concentration (BMAC)-platelet rich plasma (PRP) injection to identify the therapeutic effects of BMAC-PRP on partial tear of the rotator cuff tendon. METHODS: Twenty-four patients with partial tear of the rotator cuff tendon participated in this study. Twelve patients underwent extraction of BMACs and PRP and received the injection of BMAC-PRP at the tear site under ultrasound guidance...
January 3, 2018: Journal of Orthopaedic Surgery and Research
Alyssa N Ball, Seth W Donahue, Samantha J Wojda, C Wayne McIlwraith, Christopher E Kawcak, Nicole Ehrhart, Laurie R Goodrich
Conventional clinical management of complex bone healing scenarios continues to result in 5-10% of fractures forming non-unions. Additionally, the aging population and prevalence of osteoporosis-related fractures necessitate the further exploration of novel ways to augment osteogenesis in this special population. This review focuses on the current clinical modalities available, and the ongoing clinical and pre-clinical research to promote osteogenesis in segmental bone defects, delayed unions, and osteoporosis...
December 27, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Eric J Cotter, Kevin C Wang, Adam B Yanke, Susan Chubinskaya
Objective To critically evaluate the current basic science, translational, and clinical data regarding bone marrow aspirate concentrate (BMAC) in the setting of focal cartilage defects of the knee and describe clinical indications and future research questions surrounding the clinical utility of BMAC for treatment of these lesions. Design A literature search was performed using the PubMed and Ovid MEDLINE databases for studies in English (1980-2017) using keywords, including ["bone marrow aspirate" and "cartilage"], ["mesenchymal stem cells" and "cartilage"], and ["bone marrow aspirate" and "mesenchymal stem cells" and "orthopedics"]...
November 1, 2017: Cartilage
Suelen Castro Lavareda Corrêa, Juliana Elias de Sousa, Paulo José Pasquali, Luís Guilherme Scavone de Macedo, Antonio Carlos Aloise, Marcelo Lucchesi Teixeira, André Antonio Pelegrine
OBJECTIVES: To evaluate bone allograft associated to bone marrow aspirate concentrate (BMAC), in maxillary reconstructions. MATERIALS AND METHODS: Ten patients with alveolar bone deficiency in the anterior maxilla were randomly divided into control group (CG) and test group (TG). A bone block allograft was placed in both groups, but the graft was impregnated with BMAC only in TG. Computed tomography was performed 7 days (T1) and 6 months (T2) after the grafting procedure, and volume and bone density measurements were carried out...
December 2017: Implant Dentistry
Mohamed A Imam, James Holton, Saman Horriat, Ahmed S Negida, Florian Grubhofer, Rohit Gupta, Ali Narvani, Martyn Snow
Tendon pathologies are a group of musculoskeletal conditions frequently seen in clinical practice. They can be broadly classified into traumatic, degenerative and overuse-related tendinopathies. Rotator cuff tears, Achilles tendinopathy and tennis elbow are common examples of these conditions. Conventional treatments have shown inconsistent outcomes and might fail to provide satisfactory clinical improvement. With the growing trend towards the use of mesenchymal stem cells (MSCs) in other branches of medicine, there is an increasing interest in treating tendon pathologies using the bone marrow MSC...
2017: SICOT-J
Jean-Philippe Hauzeur, Viviane De Maertelaer, Etienne Baudoux, Michel Malaise, Yves Beguin, Valérie Gangji
PURPOSE: The fracture stage of non-traumatic osteonecrosis (ON stage 3) of the femoral head (ONFH) has an unfavourable prognosis frequently requiring total hip replacement (THR). The percentage could be lowered after core decompression. In earlier non-fracture ON stages, implantation of autologous bone marrow aspirate concentrate (BMAC) improved the effect of core decompression. The purpose was to evaluate the effect of BMAC in addition to core decompression in stage 3 ONFH. METHODS: A double blind RCT was conducted comparing two groups: core decompression plus saline injection or core decompression plus BMAC implantation...
October 7, 2017: International Orthopaedics
Gilbert Moatshe, Elizabeth R Morris, Mark E Cinque, Cecilia Pascual-Garrido, Jorge Chahla, Lars Engebretsen, Robert F Laprade
- Knee pathologies including focal cartilage injuries, osteoarthritis (OA), and ligament injuries are common. The poor regeneration and healing potential of cartilage has led to the search for other treatment modalities with improved healing capacity. Furthermore, with an increasing elderly population that desires to remain active, the burden of knee pathologies is expected to increase. Increased sports participation and the desire to return to activities faster is also demanding more effective and minimally invasive treatment options...
December 2017: Acta Orthopaedica
Mohamed A Imam, James Holton, Lukas Ernstbrunner, Wojciech Pepke, Florian Grubhofer, Ali Narvani, Martyn Snow
PURPOSE: Fracture healing encompasses a succession of dynamic multifactorial metabolic events, which ultimately re-establishes the integrity of the biomechanical properties of the bone. Up to 10% of the fractures occurring annually will need additional surgical procedures because of impaired healing. The aim of this article is to review the current literature regarding the use of bone marrow aspirate concentrate (BMAC) and its effectiveness in the management of bone defects. METHODS: We have included all published clinical literature investigating the development, techniques and applications of BMAC...
November 2017: International Orthopaedics
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: To evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective case control. SETTING: Level 1 trauma center. PATIENTS: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1-year follow-up. INTERVENTION: Operative treatment with antegrade intramedullary nails...
July 2017: Journal of Orthopaedic Trauma
Jorge Chahla, Sandeep Mannava, Mark E Cinque, Andrew G Geeslin, David Codina, Robert F LaPrade
Bone marrow obtained by iliac crest aspiration is a common source for harvesting mesenchymal stem cells, other progenitor cells, and associated cytokine/growth factors. Recent studies have reported good to excellent outcomes with the use of bone marrow aspirate concentrate (BMAC) for pain relief in the treatment of focal chondral lesions and osteoarthritis of the knee. However, the harvesting and processing technique are crucial to achieve satisfactory results. Several studies have examined outcomes after BMAC injection, with encouraging results, but there is a lack of consensus in terms of the frequency of injection, the amount of BMAC that is injected, and the timing of BMAC injections...
April 2017: Arthroscopy Techniques
Hakan Pilge, Bernd Bittersohl, Johannes Schneppendahl, Tobias Hesper, Christoph Zilkens, Martin Ruppert, Rüdiger Krauspe, Marcus Jäger
With disease progression, avascular necrosis (AVN) of the femoral head may lead to a collapse of the articular surface. The exact pathophysiology of AVN remains unclear, although several conditions are known that can result in spontaneous cell death, leading to a reduction of trabecular bone and the development of AVN. Hip AVN treatment is stage-dependent in which two main stages of the disease can be distinguished: pre-collapse (ARCO 0-II) and post-collapse stage (ARCO III-IV, crescent sign). In the pre-collapse phase, core decompression (CD), with or without the addition of bone marrow (e...
November 17, 2016: Orthopedic Reviews
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: High rates of implant failure and nonunion in atypical femur fractures (AFF) have been reported. The aim of this study was to evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective Case Control SETTING:: Level 1 Trauma Center PATIENTS:: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1 year follow up. INTERVENTION: Operative treatment with anterograde intramedullary (IM) nails...
April 7, 2017: Journal of Orthopaedic Trauma
Rachel J Shakked, Emily E Walters, Martin J O'Malley
PURPOSE OF REVIEW: Navicular stress fractures are common in athletes and management is debated. This article will review the evaluation and management of navicular stress fractures. RECENT FINDINGS: Various operative and non-operative adjunctive treatment modalities are reviewed including the relevance of vitamin D levels, use of shock wave therapy and bone marrow aspirate concentrate (BMAC), and administration of teriparatide. Surgical treatment may be associated with earlier return to sports...
March 2017: Current Reviews in Musculoskeletal Medicine
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