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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...
June 30, 2016: 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...
June 21, 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
Gayathri Subramanian, Callan Bialorucki, Eda Yildirim-Ayan
In this work, we developed a nanofibrous, yet injectable orthobiologic tissue scaffold that is capable of hosting osteoprogenitor cells and controlling kinetic release profile of the encapsulated pro-osteogenic factor without diminishing its bioactivity over 21days. This innovative injectable scaffold was synthesized by incorporating electrospun and subsequently O2 plasma-functionalized polycaprolactone (PCL) nanofibers within the collagen type-I solution along with MC3T3-E1 cells (pre-osteoblasts) and bone morphogenetic protein-2 (BMP2)...
June 2015: Materials Science & Engineering. C, Materials for Biological Applications
Kurt R Weiss
Geller and colleagues report that adjuvant chemotherapy affected the adequacy of osteosarcoma local surgical control. Exogenous bone morphogenetic protein-2 (BMP-2) did not increase local recurrence, but the limited theoretical benefits of BMP-2 for a subset of patients with osteosarcoma may not justify the systemic and long-term risks.
July 1, 2015: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Shawn Gee, John Dunn, Brian Waterman, Michael Todd
We present a case of postsurgical deltoid insufficiency occurring after augmented revision of a failed prior rotator cuff repair. Revision deltoid repair with deltoid imbrication and orthobiological augmentation was dually performed, resulting in successful deltoid and rotator cuff healing and improved clinical outcomes.
January 2015: Military Medicine
Jamil Bashir, Alberto J Panero, Andrew L Sherman
Platelet-rich plasma (PRP) is one of many new developments within the expanding field of regenerative medicine. Specialists in areas such as orthopedics, physical medicine and rehabilitation, and rheumatology have been exploring the benefits of this novel therapy. Although PRP therapy remains controversial and has minimal clinical trial support, the use of orthobiologics such as PRP continues to advance as patients seek nonsurgical approaches to acute and chronic musculoskeletal injury and disease. However, academic acceptance as well as insurance reimbursement remain reliant on solid and repeatable positive results from large clinical trials...
January 2015: Journal of the American Osteopathic Association
Xiaohua Yu, Darilis Suárez-González, Andrew S Khalil, William L Murphy
"Orthobiologics" represents an important category of therapeutics for the regeneration of bone defects caused by injuries or diseases, and bone growth factors are a particularly rapidly growing sub-category. Clinical application of bone growth factors has accelerated in the last two decades with the introduction of BMPs into clinical bone repair. Optimal use of growth factor-mediated treatments heavily relies on controlled delivery, which can substantially influence the local growth factor dose, release kinetics, and biological activity...
April 2015: Advanced Drug Delivery Reviews
Barry I Rosenblum
No abstract text is available yet for this article.
January 2015: Clinics in Podiatric Medicine and Surgery
Thomas Zgonis
No abstract text is available yet for this article.
January 2015: Clinics in Podiatric Medicine and Surgery
Sean T Grambart
A Cochrane Review was performed to assess the effects of platelet-rich therapies for treating musculoskeletal soft tissue injuries. Selection criteria were randomized and quasirandomized controlled trials (RCTs) that compared platelet-rich therapy with either placebo, autologous whole blood, dry needling, or no platelet-rich therapy for people with acute or chronic musculoskeletal soft tissue injuries. Primary outcomes were functional status, pain, and adverse effects. The investigators found 19 studies that compared platelet-rich therapy with placebo, autologous whole blood, dry needling, or no platelet-rich therapy...
January 2015: Clinics in Podiatric Medicine and Surgery
Jarema S Czarnecki, Khalid Lafdi, Panagiotis A Tsonis
Carbon may represent an alternative material suitable for future development as a soft-tissue substitute that potentially optimizes the biological and mechanical properties required for a graft product used in surgery. In addition, other modes of characterization such as 3-dimensional computational modeling may offer an insight into material performance in a biological environment. Further investigation is required to characterize and model the relationships between biological, mechanical, and design properties of this material to maximize its potential as a biomechanical scaffold and vehicle for delivering biologics that promote tissue repair and regeneration...
January 2015: Clinics in Podiatric Medicine and Surgery
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