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Bone marrow aspirate concentrate and knee

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https://www.readbyqxmd.com/read/29628381/biological-treatment-for-osteoarthritis-of-the-knee-moving-from-bench-to-bedside-current-practical-concepts
#1
Jorge Chahla, Bert R Mandelbaum
Biological-based therapies for cartilage pathology have gained considerable recognition in the last few decades due to their potential benefits including their minimal invasiveness, capacity for unprecedented healing, and potential for rapid recovery. Consequently, these therapies are likely to have the most noteworthy impact on patients with degenerative joint changes who want to remain active. Currently, the most researched treatments include platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and cell-based therapies...
April 5, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29589086/subchondral-stem-cell-therapy-versus-contralateral-total-knee-arthroplasty-for-osteoarthritis-following-secondary-osteonecrosis-of-the-knee
#2
Philippe Hernigou, Jean Charles Auregan, Arnaud Dubory, Charles Henri Flouzat-Lachaniette, Nathalie Chevallier, Helene Rouard
PURPOSE: Total knee arthroplasty (TKA) implanted in patients with secondary osteonecrosis (ON) related to corticosteroids have relatively poor outcome (20% revision rate) at a mean follow-up of only eight years. With the hypothesis that subchondral bone marrow injection might improve knees in these patients, we evaluated 30 patients who had bilateral knee osteoarthritis with severe joint space narrowing and received TKA in one knee and subchondral bone marrow concentrate injection in the contralateral knee...
March 27, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29493355/a-cost-effective-cell-and-matrix-based-minimally-invasive-single-stage-chondroregenerative-technique-developed-with-validated-vertical-translation-methodology
#3
A A Shetty, S J Kim, S Ahmed, S Trattnig, S A Kim, H J Jang
Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation...
March 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29395424/rationale-and-design-of-the-clinical-and-histologic-analysis-of-mesenchymal-stromal-cells-in-amputations-champ-trial-investigating-the-therapeutic-mechanism-of-mesenchymal-stromal-cells-in-the-treatment-of-critical-limb-ischemia
#4
S Keisin Wang, Linden A Green, Natalie A Drucker, Raghu L Motaganahalli, Andres Fajardo, Michael P Murphy
OBJECTIVE: Currently, there are no accepted nonsurgical therapies that improve the delivery of blood-derived nutrients to patients with critical limb ischemia. Here, we describe the ongoing phase 1/2 Clinical and Histologic Analysis of Mesenchymal Stromal Cells in AmPutations (CHAMP) trial, which will provide crucial evidence of the safety profile of mesenchymal stromal cells (MSCs) and explore their therapeutic mechanisms in the setting of critical limb ischemia requiring below-knee amputation (BKA)...
January 30, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29348998/meniscal-repair-with-fibrin-clot-augmentation
#5
Jorge Chahla, Nicholas I Kennedy, Andrew G Geeslin, Gilbert Moatshe, Mark E Cinque, Nicholas N DePhillipo, Robert F LaPrade
Meniscal injuries and meniscal loss are associated with changes in knee kinematics and loading, ultimately leading to poor functional outcomes and increased risk of progression to osteoarthritis. Biomechanical studies have shown restored knee function, and clinical studies have reported improved outcomes and decreased risk of osteoarthritis after meniscal repair. This has led orthopaedic surgeons to try and save the meniscus by repair whenever possible, as shown by increasing incidence of meniscal repair surgeries...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29126349/bone-marrow-aspirate-concentrate-for-cartilage-defects-of-the-knee-from-bench-to-bedside-evidence
#6
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
https://www.readbyqxmd.com/read/28831830/biological-treatment-of-the-knee-with-platelet-rich-plasma-or-bone-marrow-aspirate-concentrates
#7
REVIEW
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
https://www.readbyqxmd.com/read/28654811/return-to-running-following-knee-osteochondral-repair-using-an-anti-gravity-treadmill-a-case-report
#8
Karen Hambly, Somruthai Poomsalood, Emma Mundy
BACKGROUND: The purpose of this study was to assess the impact of an anti-gravity treadmill return to running programme on self-efficacy and subjective knee function following knee osteochondral surgery. CASE DESCRIPTION: A 39-year-old otherwise healthy female endurance runner with a left knee femoral cartilage grade 3-4 defect 3 cm2 . The patient underwent single step arthroscopic microfracture with Bone Marrow Aspirate Concentrate. An AlterG® anti-gravity treadmill was used to manipulate loading during a graduated phased return to running over 8 weeks...
July 2017: Physical Therapy in Sport
https://www.readbyqxmd.com/read/28580265/bone-marrow-aspirate-concentrate-harvesting-and-processing-technique
#9
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
https://www.readbyqxmd.com/read/28580256/biologic-inlay-osteochondral-reconstruction-arthroscopic-one-step-osteochondral-lesion-repair-in-the-knee-using-morselized-bone-grafting-and-hyaluronic-acid-based-scaffold-embedded-with-bone-marrow-aspirate-concentrate
#10
Boguslaw Sadlik, Alberto Gobbi, Mariusz Puszkarz, Wojciech Klon, Graeme P Whyte
Cartilage injury of the knee that is associated with significant subchondral bone loss can result in great morbidity, and treatment options that provide durable repair are limited. Osteochondral autograft and allograft reconstruction of these lesions has been used extensively; however, these techniques often require a more invasive surgical exposure, and restoring the natural articular surface radius of curvature can be challenging, particularly in larger lesions. Cell-based repair of these lesions, using autologous chondrocytes in conjunction with bone grafting, has been used with success, although this procedure requires the patient to undergo 2 operations, and access is often restricted due to the high associated costs...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28577706/biologic-options-for-articular-cartilage-wear-platelet-rich-plasma-stem-cells-bone-marrow-aspirate-concentrate
#11
REVIEW
Matthew J Kraeutler, Jorge Chahla, Robert F LaPrade, Cecilia Pascual-Garrido
Biological treatments for articular cartilage repair have gained in popularity in the past decade. Advantages of these therapies include minimal invasiveness, improved healing time, and faster recovery. Biological therapies for cartilage repair include platelet-rich plasma, bone marrow aspirate concentrate, and cell-based therapies. These methods have the added benefit of containing growth factors and/or stem cells that aid in recovery and regeneration. The purpose of this article is to review the current cartilage treatment options and the existing literature on outcomes, complications, and safety profile of these products for use in the knee and hip joints...
July 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28409101/microdrilling-surgery-augmented-with-intra-articular-bone-marrow-aspirate-concentrate-platelet-rich-plasma-and-hyaluronic-acid-a-technique-for-cartilage-repair-in-the-knee
#12
Joseph E Broyles, M Adaire O'Brien, M Patrick Stagg
The ideal treatment of large full-thickness chondral lesions in the knee, especially "kissing lesions" and osteoarthritis, has not been determined. Microdrilling surgery augmented with injections of peripheral blood stem cells and hyaluronic acid has been used to treat patients with a wide range of articular cartilage disease including patients with bipolar lesions and joint space narrowing. Excellent results in this difficult patient population have been reported, and second-look biopsy has shown repair tissue very similar to native hyaline cartilage...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28203511/a-retrospective-look-at-integrating-a-novel-regenerative-medicine-approach-in-plastic-limb-reconstruction
#13
Edgardo R Rodriguez Collazo, Christopher R Rathbone, Brian R Barnes
Full-thickness wounds that have rendered patients candidates for amputation may require techniques that may include a combinatorial approach above traditional standard of care. The purpose of this retrospective study was to evaluate the effectiveness of an innovative approach whereby several therapies were combined to avoid amputation. Patients with full-thickness wounds who were previously recommended for amputation and were treated with the combinatorial approach of muscle flap reconstruction and concentrated bone marrow aspirate, platelet-rich plasma, INTEGRA Wound matrix, vacuum-assisted closure, and split-thickness skin grafts were assessed retrospectively...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27709058/dry-arthroscopic-single-stage-cartilage-repair-of-the-knee-using-a-hyaluronic-acid-based-scaffold-with-activated-bone-marrow-derived-mesenchymal-stem-cells
#14
Graeme P Whyte, Alberto Gobbi, Boguslaw Sadlik
Cartilage lesions of the knee are a frequent finding; however, treatment options that are capable of restoring hyaline-like tissue are not routinely used. Cell-based technology such as autologous chondrocyte implantation may in some cases provide durable cartilage repair, but availability of this procedure is often restricted due to cost constraints. There have been promising outcomes reported with the use of scaffolds seeded with activated bone marrow aspirate concentrate in cases of chondral injury. There are clear advantages to cell-based cartilage repair techniques that are performed as a single-stage procedure, particularly when the repair technology can be used in a minimally invasive manner...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27566242/a-prospective-single-blind-placebo-controlled-trial-of-bone-marrow-aspirate-concentrate-for-knee-osteoarthritis
#15
RANDOMIZED CONTROLLED TRIAL
Shane A Shapiro, Shari E Kazmerchak, Michael G Heckman, Abba C Zubair, Mary I O'Connor
BACKGROUND: Bone marrow aspirate concentrate (BMAC) is increasingly used as a regenerative therapy for musculoskeletal pathological conditions despite limited evidence-based support. HYPOTHESIS: BMAC will prove feasible, safe, and efficacious for the treatment of pain due to mild to moderate degenerative joint disease of the knee. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: In this prospective, single-blind, placebo-controlled trial, 25 patients with bilateral knee pain from bilateral osteoarthritis were randomized to receive BMAC into one knee and saline placebo into the other...
January 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27515308/identification-and-validation-of-multiple-cell-surface-markers-of-clinical-grade-adipose-derived-mesenchymal-stromal-cells-as-novel-release-criteria-for-good-manufacturing-practice-compliant-production
#16
Emily T Camilleri, Michael P Gustafson, Amel Dudakovic, Scott M Riester, Catalina Galeano Garces, Christopher R Paradise, Hideki Takai, Marcel Karperien, Simon Cool, Hee-Jeong Im Sampen, A Noelle Larson, Wenchun Qu, Jay Smith, Allan B Dietz, Andre J van Wijnen
BACKGROUND: Clinical translation of mesenchymal stromal cells (MSCs) necessitates basic characterization of the cell product since variability in biological source and processing of MSCs may impact therapeutic outcomes. Although expression of classical cell surface markers (e.g., CD90, CD73, CD105, and CD44) is used to define MSCs, identification of functionally relevant cell surface markers would provide more robust release criteria and options for quality control. In addition, cell surface expression may distinguish between MSCs from different sources, including bone marrow-derived MSCs and clinical-grade adipose-derived MSCs (AMSCs) grown in human platelet lysate (hPL)...
August 11, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27474386/one-stage-cartilage-repair-using-a-hyaluronic-acid-based-scaffold-with-activated-bone-marrow-derived-mesenchymal-stem-cells-compared-with-microfracture-five-year-follow-up
#17
Alberto Gobbi, Graeme P Whyte
BACKGROUND: Articular cartilage injury is frequently encountered, yet treatment options capable of providing durable cartilage repair are limited. PURPOSE: To investigate the medium-term clinical outcomes of cartilage repair using a 1-stage technique of a hyaluronic acid-based scaffold with activated bone marrow aspirate concentrate (HA-BMAC) and compare results with those of microfracture. A secondary aim of this study was to identify specific patient demographic factors and cartilage lesion characteristics that are associated with superior outcomes...
November 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27458895/lateral-capsular-meniscal-tear-in-a-cross-country-runner
#18
Todd P Pierce, Casey Wagner, Vincent K McInerney, Anthony Festa, Anthony J Scillia
Tears of the meniscal capsular junction present unique diagnostic and treatment challenges for practitioners because they are rich in blood supply yet often not visualized on magnetic resonance imaging. The authors report the case of a young man with a meniscal capsular junction tear, difficulties related to his diagnosis, and his short-term outcomes following surgical treatment. An 18-year-old male cross-country runner presented to the authors for nonradiating lateral right knee pain after a failed course of physical therapy...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/26871861/synergistic-action-of-il-8-and-bone-marrow-concentrate-on-cartilage-regeneration-through-upregulation-of-chondrogenic-transcription-factors
#19
Dong Suk Yoon, Kyoung-Mi Lee, Sung-Hwan Kim, Su Hee Kim, Youngmee Jung, Soo Hyun Kim, Kwang Hwan Park, Yoorim Choi, Hyun Aae Ryu, Woo Jin Choi, Jin Woo Lee
The objective of this study was to determine whether a biphasic scaffold loaded with a combination of a chemokine and bone marrow concentrate (BMC) could improve tissue regeneration in knee articular cartilage of beagles with cylindrical osteochondral defects. For this investigation, an osteochondral defect (6 mm in diameter and 8 mm deep) was created in the weight-bearing articular surface of the femoral medial condyle in beagles. Bone marrow was aspirated from the posterior iliac crests of beagles to obtain mesenchymal stem cells (MSCs) for in vitro assay...
February 2016: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/26798765/concentrated-bone-marrow-aspirate-for-the-treatment-of-chondral-injuries-and-osteoarthritis-of-the-knee-a-systematic-review-of-outcomes
#20
Jorge Chahla, Chase S Dean, Gilbert Moatshe, Cecilia Pascual-Garrido, Raphael Serra Cruz, Robert F LaPrade
BACKGROUND: Bone marrow aspirate concentrate (BMAC) has emerged as a novel treatment for pathology of the knee. Despite containing a limited number of stem cells, BMAC serves as a source of growth factors that are thought to play an important role as a result of their anabolic and anti-inflammatory effects. To our knowledge, there is no systematic review regarding the outcomes of bone marrow aspirate concentrate used for the treatment of chondral defects and osteoarthritis of the knee...
January 2016: Orthopaedic Journal of Sports Medicine
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