Cell Therapy—a Basic Science Primer for the Sports Medicine Clinician

Abstract

Purpose of Review The emergence of cell-based therapies has brought much excitement to the field of orthopedic sports medicine. However, the significant inconsistency of reporting has led to the poor understanding, misinformation, and false expectations for patients and clinicians alike. In this paper, we aim to clarify the available cell-therapy treatments and summarize some of the latest research. Recent Findings Although this technology is in early development, our understanding of cell biology has grown significantly over the last decade. Furthermore, it is becoming evident that tissue specificity may play a significant role in determining the effectiveness and overall clinical benefit attributed to cell therapy. Summary Cell therapy is an emerging field with tremendous potential for clinically significant benefit. However, in its current state, clinical application of these treatments is limited by federal regulations, variability in formulation, and limited understanding of the biologic activity of various cell formulations.

In vitro responses to platelet-rich-plasma are associated with variable clinical outcomes in patients with knee osteoarthritis

“…Similarly, leukocyte-poor PRP was more effective than conventional therapy (acetaminophen) to treat patients with early knee OA 43 . However, the functional impact of PRP to treat OA is still not conclusive because of the variable clinical results, which are believed to be related to both the variable PRP composition and to patient-intrinsic factors 3 , 15 .…”

“…The current standard methods available to clinicians to treat joint inflammation include oral non-steroidal anti-inflammatory medications and corticosteroid injection. However, these treatments are associated with variable outcomes, and as result clinicians have begun to use “orthobiologics” due to their potential to diminish inflammation and promote anabolism and repair, and because its “minimally manipulated” and autologous nature is not subjected to pre-market regulatory clearance from the Food and Drug Administration 3 .…”

“…Platelet-rich-plasma (PRP) is an autologous blood product generated by centrifugation of whole venous blood to isolate and concentrate platelets. It is believed that platelets, which contain and release numerous growth factors, promote healing, dampen inflammation, and reduce pain 3 – 5 . These blood-derived products have been used to enhance chondrogenesis 6 , 7 , treat bone 8 , 9 , tendon 10 , 11 and ligament 12 , 13 injuries, and have recently emerged as a potential therapeutic for knee OA 14 .…”

Physical Exercise in the Promotion of Gene Therapy Auxiliary Effect

“…In order to quickly find the fracture image target in the nearby area centered on the original target position, we use Kalman filter to estimate the target position of the fracture image. 7 Assign the target center position and action speed of the fracture image in the first frame to X 1 , then the estimated fracture covariance can be expressed as…”

Evaluation of Patient Preference and Perception Regarding the Clinical Use of Autologous Versus Allogeneic Cell Therapy in Orthopedic Surgery

“…Between 2009 and 2014, the number of commercial entities marketing progenitor cells as "stem cells" in the United States more than doubled each year [6]. In sports medicine, many soft tissues such as ligaments, tendons, menisci, articular cartilage, and muscles have intrinsically poor healing potential and may therefore be amenable to biologic augmentation [2]. Various progenitor cell therapy formulations are advertised as "stem cells" directly to consumers as potential therapies, but the definition of "stem cell" has been nebulous [10].…”