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ObjectiveTo evaluate the short-term safety and effectiveness of amniotic membrane/umbilical cord particulate (AMUC) in managing pain in patients with various severities of knee osteoarthritis (OA).DesignSingle-center, prospective, investigator-initiated pilot study.SettingPrivate practice.SubjectsA total of 20 knee OA patients aged ≥18 years were enrolled with pain >40 mm, as determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)–A.MethodsPatients received an ultrasound-guided, intra-articular injection of 50 mg of AMUC particulate reconstituted in 2 mL of preservative-free saline. All patients were then monitored at six weeks, 12 weeks, and 24 weeks postinjection. Patients who did not show >30% reduction in pain received a second injection of AMUC at six weeks. WOMAC, Patient Global Assessment, medication usage, and magnetic resonance imaging (MRI) were assessed.ResultsKnee OA pain significantly decreased from 74.3 ± 17.2 at baseline to 45.0 ± 25.4 at six weeks (P < 0.01), 35.4 ± 26.6 at 12 weeks (P < 0.001), and 37.4 ± 26.7 at 24 weeks (P < 0.001). This pain reduction was associated with a significant improvement in physical function (WOMAC-C) at all time points (P < 0.05) and stiffness (WOMAC-B) at 12 weeks (P = 0.01). Eleven patients received a second injection, which was significantly correlated with body mass index >30 kg/m2 (P = 0.025). MRI evaluation of the overall population revealed an improvement in the severity of bone marrow lesions in seven patients. No adverse events were observed.ConclusionsAMUC particulate injection relieved pain and improved physical function in patients with symptomatic knee OA.

The peninsular pronghorn (Antilocapra americana peninsularis) in the Baja California peninsula is an endangered subspecies. We constructed captive breeding facilities in the Vizcaino Desert within the current range of peninsular pronghorn to assist in population recovery. The captive breeding facilities included fences, shade, feeders, an irrigation system, observation towers, housing for caretakers, and a visitor center. We document the initial 6‐year cycle of the captive management, 1 step of the recovery effort, from the first capture of 5 fawns in 1998 to 90 captive peninsular pronghorns by the end of 2003. We identified problems with the captive breeding facility (e.g., identification of animals and movements into, and accidents with, fences), but overall the facility has been a success. We projected the first potential translocation of animals into the wild in 2004. If the translocation of captive animals is successful, peninsular pronghorn may begin the recovery process in the wild.

BACKGROUND: Facet joint syndrome (FJS) pain is a significant contributor to back pain and has a high rate of opioid prescription. Unfortunately, there are a limited number of therapeutic options for these patients. OBJECTIVE: To evaluate the safety and effectiveness of amniotic membrane/umbilical cord particulate (AM/UC) in managing FJS pain. METHODS: A single-center, investigator-initiated, retrospective study was performed on consecutive patients with FJS pain who received intra- or peri-articular injection of AM/UC between July 1, 2018 and July 26, 2019. Primary outcome was change in Patient Global Impression of Change (PGIC) at 6 weeks, 3 months, 6 months, and 12 months to assess the self-reported percent improvement relative to baseline. Safety was assessed by AM/UC- and procedure-related complications. Paired t-tests were used to determine whether there is a statistically significant improvement of pain post-injection compared to baseline. RESULTS: There were a total of 54 patients (69.7 ± 13.4 years; 31 female) presenting baseline pain score of 9.2 ± 1.0 despite prior treatments of activity modification (66.7%), NSAIDs (61.1%), opioids (37.0%), and physical therapy (35.2%). Mean GPIC improvement was 65.3%, 67.5%, 56.9%, and 56.7% among responders30, respectively. There were no complications. CONCLUSION: This study supports the safety and effectiveness of AM/UC particulate injection in managing FJS pain.