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Blake Boggess, Claude Moorman
No abstract text is available yet for this article.
March 2017: Current Sports Medicine Reports
Jae Sung Lee, Xiaohua Yu, Amy J Wagoner Johnson, William L Murphy
Although calcium phosphate (CaP) binding peptides are used to link orthobiologics to orthopedic biomaterials, their binding stability in physiological environment is still unknown. In this study, we investigate the binding capability of a series of CaP-binding peptides and their binding stability in serum solutions, which are selected to resemble physiological conditions. The findings in this study may be applicable for designing robust orthobiologic delivery systems.
March 6, 2017: Biomaterials Science
Sheldon S Lin
No abstract text is available yet for this article.
December 2016: Foot and Ankle Clinics
Joshua S Harford, Travis J Dekker, Samuel B Adams
Autologous bone marrow aspirate concentrate (BMAC) has become a popular orthobiologic to augment bone healing. The potential benefit comes from osteoprogenitor cells and growth factors that can lead to new bone formation in the setting of foot and ankle arthrodesis procedures. BMAC has an excellent safety record and has demonstrated efficacy in animal models of bone healing. Although scant, the literature on the use of BMAC in foot and ankle surgery does demonstrate promise for this orthobiologic adjuvant.
December 2016: Foot and Ankle Clinics
H Thomas Temple, Theodore I Malinin
Many allogeneic biologic materials, by themselves or in combination with cells or cell products, may be transformative in healing or regeneration of musculoskeletal bone and soft tissues. By reconfiguring the size, shape, and methods of tissue preparation to improve deliverability and storage, unique iterations of traditional tissue scaffolds have emerged. These new iterations, combined with new cell technologies, have shaped an exciting platform of regenerative products that are effective and provide a bridge to newer and better methods of providing care for orthopedic foot and ankle patients...
December 2016: Foot and Ankle Clinics
Sheldon S Lin, Michael G Yeranosian
Nonunion after tibial shaft fracture and hindfoot arthrodesis remains a major problem. Known risk factors include advanced age, immunosuppression, smoking, and diabetes. Several factors must be considered in the fracture healing process. This review evaluates the efficacy of orthobiologics in improving union rates after fracture or arthrodesis. Use of compounds have shown increased cellular proliferation experimentally. Percutaneous autologous bone marrow has shown increased cellular proliferation. Matrix supplementation has shown significant improvements in bone healing...
December 2016: Foot and Ankle Clinics
Taylor P Gurnea, Wesley P Frye, Peter L Althausen
In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can be based on good scientific evidence, which supports specific cost saving measures. Careful attention to blood utilization and use of tranexamic acid has the potential to save millions in the hip fracture treatment and arthroplasty treatments...
December 2016: Journal of Orthopaedic Trauma
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
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
Bert R Mandelbaum
Articular cartilage lesions, whether acute or chronic, are among the most common and difficult-to-treat conditions of the knee in the adolescent and athletic population. The results from a study in this issue as well as some in the previous literature suggest that autologous chondrocyte implantation yields long-term improvement in function and symptoms and may be a viable treatment for young to adult athletes or patients with high physical demands and a long active lifespan. No intervention in the young symptomatic patient will yield inferior results because it appears that no treatment over time has deleterious effects...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Dianne Bryant, Richard Holtby, Kevin Willits, Robert Litchfield, Darren Drosdowech, Alison Spouge, David White, Gordon Guyatt
BACKGROUND: The rate of rotator cuff repair failure is between 13% and 67%. Porcine small intestine submucosa (SIS) may be suitable to augment the repair. METHODS: There were 62 patients with moderate and large cuff tears randomized to repair alone (control) or augmentation with SIS (Restore Orthobiologic Implant; DePuy, Warsaw, IN, USA). Primary outcome was repair failure using magnetic resonance arthrography. Randomization occurred on completion of the repair...
October 2016: Journal of Shoulder and Elbow Surgery
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
Gordon D Ko, Sean Mindra, Gordon E Lawson, Scott Whitmore, Leigh Arseneau
BACKGROUND: Two-thirds of adults worldwide will experience low back pain at some point in their life. In the following case series, we present four patients with sacroiliac (SI) joint instability and severe chronic low back pain, which was refractory to other treatment modalities. OBJECTIVE: We investigated the efficacy of platelet-rich plasma (PRP) injections, a novel orthobiologic therapy, for reducing SI joint pain, improving quality of life, and maintaining a clinical effect...
2017: Journal of Back and Musculoskeletal Rehabilitation
Gilberto Vizcaíno
In recent years there has been a boom in the use of platelet-rich plasma (PRP) as an orthobiology (therapy based on cell biological agents) material agent. The presence of growth factors and other bioactive agents stored in alpha platelet granules and whose properties are well determined in cell proliferation, angiogenesis and extracellular matrix formation have involved the PRP containing supraphysiological concentrations of autologous platelets in tissue regeneration processes. The relative ease of preparation of PRP, its generally ambulatory application, the almost complete absence of side effects and the possibility to observe satisfactory results of clinical improvement makes the PRP a promising treatment in regenerative processes...
March 2016: Investigación Clínica
J Leuzinger, C Sternberg, D Smolen, R Jakob
Background: Massive rotator cuff tendon tears have a poor clinical prognosis. This holds especially true in older patients and after revision surgery. In order to reduce tears and increase long term shoulder parameters, patches made of a variety of materials have been applied to reinforce sutures in current orthopaedic practice. Material and Methods: In a clinical study on rotator cuff surgery from 2005 to 2011 (date of surgical intervention), we tested the efficacy of three different commercial patches, with 89 patients (63 m/26 w) enrolled with a mean age of over 60...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Kathryn M O'Connor, Jeffrey E Johnson, Jeremy James McCormick, Sandra E Klein
BACKGROUND: Arthrodesis is a common operative procedure used to manage arthritis and deformity in the foot and ankle. Nonunion is a possible and undesirable outcome in any arthrodesis surgery. Rates of nonunion in the foot and ankle literature range from 0% to 47% depending on the patient population and joint involved. Multiple factors can contribute to developing a nonunion including location, fixation method, tobacco use, diabetes, infection, and others. METHODS: The case logs of 3 foot and ankle surgeons were reviewed from January 2007 to September 2014 to identify nonunion arthrodesis revision cases...
August 2016: Foot & Ankle International
Zeiad Alshameeri, Andrew McCaskie
The potential regenerative role of different orthobiologics is becoming more recognized for the treatment of chronic and degenerative musculoskeletal conditions. Over the last few years there has been an increasing number of publications on cell therapy and other orthobiologics for the treatment of avascular necrosis of the femoral head and other hip conditions with promising short-term clinical results. In this article, we have used a systematic search of the literature to identify potentially relevant topics on orthobiologics and then selected those most applicable to hip preservation surgery...
December 2015: Journal of Hip Preservation Surgery
Sheldon S Lin, Nicholas J Montemurro, Ethan S Krell
Exploration into the molecular aspects of the healing process has led to the development of autologous and recombinant biologic agents. These products, collectively known as orthobiologics, have the potential to optimize favorable outcomes with respect to bone and soft-tissue restoration and to maximize the natural healing response. These orthobiologics include platelet-derived growth factor, bone morphogenetic proteins, and platelet-rich plasma. Although the usefulness of these growth factors is well described in various fields of surgery, few data exist to support or oppose the specific application of growth factors in foot and ankle surgery...
February 2016: Journal of the American Academy of Orthopaedic Surgeons
Craig R Lareau, Matthew E Deren, Amanda Fantry, Rafe M J Donahue, Christopher W DiGiovanni
BACKGROUND: While autogenous cancellous iliac crest bone graft is the gold standard for foot and ankle surgery, it lacks Level I evidence. Although one third of all graft cases performed in the United States today rely on allograft, some surgeons believe no graft is necessary. We hypothesized that a systematic review of the foot and ankle literature would reveal that (1) autogenous bone graft during foot and ankle arthrodesis would demonstrate healing rates that were superior to the use of either using allograft or no bone graft at all, and (2) these differences would be even more dramatic in patients having risk factors that impair bone healing...
September 2015: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Vijay G Goni, Sampat Singh Jhala, Nirmal Raj Gopinathan, Prateek Behera, Y K Batra, Arjun R H H, Uday Guled, Harsha Vardhan
STUDY DESIGN: Prospective randomized pilot study. OBJECTIVE: Evaluation of the efficacy of epidural perineural injection of autologous conditioned serum (ACS) versus methylprednisone (MPS) in unilateral cervical radiculopathy patients. SUMMARY OF BACKGROUND DATA: Cervical radiculopathy is often treated by nonoperative and operative means. Guided injections of steroids have been used previously. We used ACS, an orthobiologic derived from patients' own blood in patients of unilateral cervical radiculopathy...
August 15, 2015: Spine
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