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Bone marrow aspirate concentrate and knee

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
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
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
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
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
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
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
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
Aaron J Krych, Danyal H Nawabi, Nadja A Farshad-Amacker, Kristofer J Jones, Travis G Maak, Hollis G Potter, Riley J Williams
BACKGROUND: Limited information exists on the clinical use of a synthetic osteochondral scaffold plug for cartilage restoration in the knee. PURPOSE/HYPOTHESIS: The purpose of this study was to compare the early magnetic resonance imaging (MRI) appearance, including quantitative T2 values, between cartilage defects treated with a scaffold versus a scaffold with platelet-rich plasma (PRP) or bone marrow aspirate concentrate (BMAC). The hypothesis was that the addition of PRP or BMAC would result in an improved cartilage appearance...
January 2016: American Journal of Sports Medicine
Alberto Gobbi, Sanyam Chaurasia, Georgios Karnatzikos, Norimasa Nakamura
OBJECTIVE: To compare the outcome of matrix-induced autologous chondrocyte implantation (MACI) and bone marrow aspirate concentrate (BMAC)-derived multipotent stem cells (MSCs) implantation in patellofemoral chondral lesions, using the same HYAFF11 scaffold. METHODS: From January 2005 to December 2010, 37 patients with patellofemoral chondral lesions were prospectively followed up, for a minimum of 3 years; 19 of these patients were treated with MACI and 18 with BMAC...
April 2015: Cartilage
John G Kennedy, Christopher D Murawski
OBJECTIVE: To present the functional results after autologous osteochondral transplantation with bone marrow aspirate concentrate in 72 patients, while placing an emphasis on the surgical technique. METHODS: Between 2005 and 2009, 72 patients underwent autologous osteochondral transplantation under the care of the senior author. The mean patient age at the time of surgery was 34.19 years (range, 16-85 years). All patients were followed for a minimum of 1 year after surgery...
October 2011: Cartilage
Alberto Gobbi, Georgios Karnatzikos, Celeste Scotti, Vivek Mahajan, Laura Mazzucco, Brunella Grigolo
OBJECTIVE: The purpose of our study was to determine the effectiveness of cartilage repair utilizing 1-step surgery with bone marrow aspirate concentrate (BMAC) and a collagen I/III matrix (Chondro-Gide, Geistlich, Wolhusen, Switzerland). MATERIALS AND METHODS: We prospectively followed up for 2 years 15 patients (mean age, 48 years) who were operated for grade IV cartilage lesions of the knee. Six of the patients had multiple chondral lesions; the average size of the lesions was 9...
July 2011: Cartilage
Javier Narbona-Carceles, Javier Vaquero, Susana B S Suárez-Sancho, Francisco Forriol, Maria Eugenia Fernández-Santos
INTRODUCTION: The most common method to obtain human mesenchymal stem cells (MSCs) is bone marrow aspiration from the iliac crest, but MSCs have also been isolated from different bones. The main purpose of this study was to compare bone marrow MSCs aspirated from the metaphysis of the distal femur and the proximal tibia with those obtained from the iliac crest, and to determine whether these locations represent potential alternative sources of MSCs for research and clinical application...
October 2014: Injury
Evan W James, Christopher M LaPrade, John A Feagin, Robert F LaPrade
Complete radial meniscus tears have been reported to result in deleterious effects in the knee joint if left unrepaired. An emphasis on meniscal preservation is important in order to restore native meniscal function. In this case report, a complete radial tear of the medial meniscus midbody was repaired using a novel crisscross suture transtibial technique. This technique secured the anterior and posterior meniscal horns, which were released from their extruded and scarred position along the capsule, using crisscrossing sutures passed through two transtibial tunnels and secured over a bone bridge on the anterolateral tibia...
September 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Marcel Betsch, Simon Thelen, Laila Santak, Monika Herten, Pascal Jungbluth, Daniel Miersch, Mohssen Hakimi, Michael Wild
BACKGROUND: All available treatment options for osteochondral and chondral defects do not restore hyaline cartilage and are limited to decreasing associated pain, and maintaining or improving joint function. The purpose of this study was to evaluate the potential of erythropoietin (EPO) in combination with bone marrow aspiration concentrate (BMAC) in the treatment of osteochondral defects of mini-pigs. METHODS: 14 Goettinger mini-pigs, in which a 6 × 10 mm osteochondral defect in the medial femoral condyle of both knee joints was created, were randomized into four groups: biphasic scaffold alone, scaffold with EPO, scaffold with BMAC and scaffold in combination with EPO and BMAC...
2014: PloS One
Jae-Do Kim, Gun Woo Lee, Gu Hee Jung, Cheung Kue Kim, Taehun Kim, Jin Hyung Park, Seong Sook Cha, Young-Bin You
PURPOSE: As a treatment method of degenerative arthritis of knee, this study evaluated the clinical efficacy of the intra-articular injection of autologous bone marrow aspirates concentrate (BMAC) with adipose tissue. MATERIALS AND METHODS: Between April 2011 and May 2012, 41 patients (75 knees) who were diagnosed as a degenerative knee arthritis and underwent the BMAC injection with adipose tissue were included in this study. Mean age was 60.7 years old (ranged 53-80)...
December 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Ross A Hauser, Amos Orlofsky
Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months...
2013: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Antonio Gigante, Stefano Cecconi, Silvano Calcagno, Alberto Busilacchi, Davide Enea
In recent years several single-stage cartilage repair approaches have been devised to treat focal cartilage lesions. These usually associate microfracture (MFX) and a coverage scaffold. We describe a novel arthroscopic technique that combines MFX, autologous bone marrow concentrate (BMC), and a protective scaffold. Bone marrow aspirate from the iliac crest is centrifuged to obtain BMC. The cartilage defect is debrided, MFX holes are created, and the final defect is measured by use of a bent K-wire. The scaffold is then shaped to match the defect, immersed in BMC, introduced into the joint with a grasper, and fixed in place with a mixture of fibrin glue and BMC...
December 2012: Arthroscopy Techniques
Lars Rackwitz, Lars Eden, Stephan Reppenhagen, Johannes C Reichert, Franz Jakob, Heike Walles, Oliver Pullig, Rocky S Tuan, Maximilian Rudert, Ulrich Nöth
Avascular necrosis (AVN) of the femoral head is a debilitating disease of multifactorial genesis, predominately affects young patients, and often leads to the development of secondary osteoarthritis. The evolving field of regenerative medicine offers promising treatment strategies using cells, biomaterial scaffolds, and bioactive factors, which might improve clinical outcome. Early stages of AVN with preserved structural integrity of the subchondral plate are accessible to retrograde surgical procedures, such as core decompression to reduce the intraosseous pressure and to induce bone remodeling...
2012: Stem Cell Research & Therapy
Knut Beitzel, Mary Beth McCarthy, Mark P Cote, David Chowaniec, Lauryn M Falcone, Justine A Falcone, Evan M Dugdale, Thomas M Deberardino, Robert A Arciero, Augustus D Mazzocca
PURPOSE: (1) To safely obtain bone marrow aspirates from the distal femur during arthroscopic knee surgery, (2) to purify and efficiently concentrate connective tissue progenitor cells (CTPs) in the operating room (OR), and (3) to confirm that these are CTPs through their ability to differentiate into bone cells. METHODS: Bone marrow aspirates were harvested from the distal femur during arthroscopic knee surgery in 26 patients. Twenty-five matched control subjects were selected to evaluate for increased incidence of complications...
January 2012: Arthroscopy: the Journal of Arthroscopic & related Surgery
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