Combined Therapy with Shock Wave and Retrograde Bone Marrow-Derived Cell Transplantation for Osteochondral Lesions of the Talus

Gao, Fuqiang; Chen, Na; Sun, Wei; Wang, Bailiang; Shi, Zhencai; Cheng, Liming; Li, Zirong; Guo, Wanshou

doi:10.1038/s41598-017-02378-9

Cited by 12 publications

(24 citation statements)

References 38 publications

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“…43,52,59,61 -63,66,81,92,93,109,113,117,121,123,125,131,135,141,143,146,149,150,153,158,164,165,167,168,171,173,176,177,179 -183,187,190,192,195 -200,202,204 -206 b Significantly different from metal implants ( Q = 3.86, P = 0.0493). 11,42,53,56,59,116,118,137,170,177,194,196 c…”

Section: Resultsmentioning

confidence: 99%

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The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

et al. 2023

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Objective The primary aim was to determine and compare the complication rate of different surgical treatment options for osteochondral lesions of the talus (OLTs). The secondary aim was to analyze and compare the severity and types of complications. Design A literature search was performed in MEDLINE (PubMed), EMBASE (Ovid), and the Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Primary outcome was the complication rate per surgical treatment option. Secondary outcomes included the severity (using the Modified Clavien-Dindo-Sink Complication Classification System for Orthopedic Surgery) and types of complications. The primary outcome, the severity, and the sub-analyses were analyzed using a random effects model. A moderator test for subgroup-analysis was used to determine differences. The types of complications were presented as rates. Results In all, 178 articles from the literature search were included for analysis, comprising 6,962 OLTs with a pooled mean age of 35.5 years and follow-up of 46.3 months. Methodological quality was fair. The overall complication rate was 5% (4%-6%; treatment group effect, P = 0.0015). Analysis resulted in rates from 3% (2%-4%) for matrix-assisted bone marrow stimulation to 15% (5%-35%) for metal implants. Nerve injury was the most observed complication. Conclusions In 1 out of 20 patients treated surgically for an OLT, a complication occurs. Metal implants have a significantly higher complication rate compared with other treatment modalities. No life-threatening complications were reported.

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Section: Resultsmentioning

confidence: 99%

“… b Significantly different from metal implants ( Q = 3.86, P = 0.0493). 11,42,53,56,59,116,118,137,170,177,194,196 …”

Section: Resultsmentioning

confidence: 99%

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

et al. 2023

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“…The most often reported operative technique was BMS alone with 11 papers including 576 patients ( 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ). More than half of the patients (996/total 1695 patients) received BMS alone, BMS with an additional therapy ( 18 , 19 , 23 , 24 , 25 , 26 , 27 ) or AMIC ( 28 , 29 , 30 , 31 , 32 ) .…”

Section: Resultsmentioning

confidence: 99%

“…The most often reported operative technique was BMS alone with 11 papers including 576 patients (13,14,15,16,17,18,19,20,21,22,23). More than half of the patients (996/total 1695 patients) received BMS alone, BMS with an additional therapy (18,19,23,24,25,26,27) or AMIC (28,29,30,31,32) . BMS alone and BMS with an additional therapy were used in smaller lesions (0.88 cm 2 and 0.86 cm 2 , respectively) than the other therapies (1.86 cm 2 , P < 0.001).…”

Section: Operative Techniquesmentioning

confidence: 99%

Evidence for operative treatment of talar osteochondral lesions: a systematic review

et al. 2022

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Purpose Operative treatment of talar osteochondral lesions is challenging with various treatment options. The aims were (i) to compare patient populations between the different treatment options in terms of demographic data and lesion size and (ii) to correlate the outcome with demographic parameters and preoperative scores. Methods A systemic review was conducted according to the PRISMA guidelines. The electronic databases Pubmed (MEDLINE) and Embase were screened for reports with the following inclusion criteria: minimum 2-year follow-up after operative treatment of a talar osteochondral lesion in at least ten adult patients and published between 2000 and 2020. Results Forty-five papers were included. Small lesions were treated using BMS, while large lesions with ACI. There was no difference in age between the treatment groups. There was a correlation between preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score and change in AOFAS score (R = −0.849, P < 0.001) as well as AOFAS score at follow-up (R = 0.421, P = 0.008). Preoperative size of the cartilage lesion correlates with preoperative AOFAS scores (R= −0.634, P = 0.001) and with change in AOFAS score (R = 0.656, P < 0.001) but not with AOFAS score at follow-up. Due to the heterogeneity of the studies, a comparison of the outcome between the different operative techniques was not possible. Conclusion Patient groups with bigger lesions and inferior preoperative scores did improve the most after surgery. Level of evidence IV.

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“…These effects are concomitant with the control of local and systemic inflammation and reduced synthesis and secretion of TNF-α and NGF. As a physical therapy, LESW could exert a “cavitation effect,” which induces lots of “micro-bubbles” in local tissue that might generate “shear stress” on the cell membrane, neural axon, extracellular matrix, and cell skeleton system or related signaling pathways, such as the actin-integrin-fibronectin-collagen signaling pathway, SDF-1-CXCR4 signaling pathway, and NGF-p75NTR signaling pathway [9171819]. Among these, NGF is the most widely studied factor in IC/PBS.…”

Section: Discussionmentioning

confidence: 99%

Treatment with low-energy shock wave alleviates pain in an animal model of uroplakin 3A-induced autoimmune interstitial cystitis/painful bladder syndrome

Zhang

Peng

et al. 2019

Investig Clin Urol

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Purpose To investigate whether treatment with low-energy shock wave (LESW) alleviates pain and bladder dysfunction in a mouse model of uroplakin 3A (UPK3A)-induced interstitial cystitis/painful bladder syndrome (IC/PBS). Materials and Methods Forty female BALB/c mice were divided into four groups (n=10/group): Sham, Sham+LESW, UPK3A, and UPK3A+LESW. At 6 weeks of age, mice were injected with an emulsion containing water and complete Freund's adjuvant with (UPK3A and UPK3A+LESW groups) or without (Sham and Sham+LESW groups) 200 µg of UPK3A. At 10 weeks, mice received a second dose of Freund's adjuvant to booster immunization. At 12 weeks, mice underwent pain assessment and a frequency volume chart (FVC) test as the pretreatment assessment. LESW treatment and pain assessment were conducted from 13 to 15 weeks. One week after the final treatment, pain assessment and the FVC were conducted again as the post-treatment assessment. Mice were euthanized and sacrificed at 17 weeks. Results The presence of tactile allodynia and bladder dysfunction was significant in the UPK3A-injected mice. LESW raised the pain threshold and improved bladder function with decreased urinary frequency and increased mean urine output. Expression and secretion of local and systemic inflammatory markers, including tumor necrosis factor-α (TNF-α) and nerve growth factor (NGF), increased after UPK3A immunization. These markers were significantly decreased after LESW treatment (p<0.05). Conclusions LESW treatment attenuated pain and bladder dysfunction in a UPK3A-induced model of IC/PBS. Local and systemic inflammation was partially controlled, with a reduced number of infiltrated inflammatory cells and reduced levels of TNF-α and NGF.

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Combined Therapy with Shock Wave and Retrograde Bone Marrow-Derived Cell Transplantation for Osteochondral Lesions of the Talus

Cited by 12 publications

References 38 publications

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions

Evidence for operative treatment of talar osteochondral lesions: a systematic review

Treatment with low-energy shock wave alleviates pain in an animal model of uroplakin 3A-induced autoimmune interstitial cystitis/painful bladder syndrome

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