Cryopreserved amniotic membrane and umbilical cord particulate matrix for partial rotator cuff tears

Kolosky, Michael; Gurin, Danielle; Hampton, Robert; Masin, Richard; Krahe, David

doi:10.1097/md.0000000000016569

Cited by 22 publications

(14 citation statements)

References 51 publications

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“…A variety of flowable CTMs are now commercially available for the augmentation of tendon repair [ 2 , 8 , 20 , 22 , 23 , 35 ]. Human placental CTMs represent a unique subset of biological scaffold particulates, given the inherent structural, biochemical, and immunogenic properties of placental tissue [ 23 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

A decellularized flowable placental connective tissue matrix supports cellular functions of human tenocytes in vitro

Mao

John

Protzman³

et al. 2022

J EXP ORTOP

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Purpose Injectable connective tissue matrices (CTMs) may promote tendon healing, given their minimally invasive properties, structural and biochemical extracellular matrix components, and capacity to fill irregular spaces. The purpose of this study is to evaluate the effects of placental CTMs on the cellular activities of human tenocytes. Decellularization, the removal of cells, cell fragments, and DNA from CTMs, has been shown to reduce the host’s inflammatory response. Therefore, the authors hypothesize that a decellularized CTM will provide a more cell-friendly matrix to support tenocyte functions. Methods Three human placental CTMs were selected for comparison: AmnioFill® (A-CTM), a minimally manipulated, non-viable cellular particulate, BioRenew™ (B-CTM), a liquid matrix, and Interfyl® (I-CTM), a decellularized flowable particulate. Adhesion and proliferation were evaluated using cell viability assays and tenocyte migration using a transwell migration assay. Gene expression of tenocyte markers, cytokines, growth factors, and matrix metalloprotease (MMP) in tenocytes were assessed using quantitative polymerase chain reaction. Results Although A-CTM supported more tenocyte adhesion, I-CTM promoted significantly more tenocyte proliferation compared with A-CTM and B-CTM. Unlike A-CTM, tenocyte migration was higher in I-CTM than the control. The presence of I-CTM also prevented the loss of tenocyte phenotype, attenuated the expression of pro-inflammatory cytokines, growth factors, and MMP, and promoted the expression of antifibrotic growth factor, TGFβ3. Conclusion Compared with A-CTM and B-CTM, I-CTM interacted more favorably with human tenocytes in vitro. I-CTM supported tenocyte proliferation with reduced de-differentiation and attenuation of the inflammatory response, suggesting that I-CTM may support tendon healing and regeneration in vivo.

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Section: Introductionmentioning

confidence: 99%

A decellularized flowable placental connective tissue matrix supports cellular functions of human tenocytes in vitro

Mao

John

Protzman³

et al. 2022

J EXP ORTOP

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“…UCT stimulates various metabolic processes such as general protein and collagen synthesis, which in turn reduce pain. UCT is safe in humans and animals and its uses include burn treatment, painful chronic wound healing, and in the shoulder, foot, and ankle surgeries [22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Homologous Use of Allogeneic Umbilical Cord Tissue to Reduce Knee Pain and Improve Knee Function

Timmons

Sugaya

Bane

2022

Life

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To determine if knee pain subjects who received cryopreserved umbilical cord tissue (UCT) injected into knee joints experience less knee pain, better function, decreased physical limitations, and reduction of medications (opiates, NSAIDs, and acetaminophen) over a 24 week period, Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and medication usage data were recorded for 30 consenting human knee pain subjects receiving UCT at a single site in the United States. Subject profile information was gathered and analyzed to gain insight into the effects of age, sex, and BMI on improvement over time. Mean resting VAS scores and mean VAS scores with activity improved over 24 weeks (from 1.95 to 0.83 and from 6.28 to 2.87, respectively, p < 0.001). There was no strong evidence of a correlation between sex and VAS scores. There were statistically significant correlations for BMI vs. pre-injection VAS with activity scores and Age vs. pre-injection VAS with activity scores (r = 0.402, p = 0.028 and r = 0.434, p = 0.017, respectively). Mean WOMAC scores improved from 44.7 to 18.5 over 24 weeks (p < 0.001). 77.8% of patients who used medications at the beginning of the study reduced or eliminated medication use. The analysis demonstrates that injections with UCT decrease pain, improve physical function, and allow for less medication use for at least 24 weeks.

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“…Ackley et al 46 injected 50 mg of amniotic membrane and umbilical cord particulate matrix as part of non-operative treatment in 10 patients with partial rotator cuff tears. Improved functional outcome scores were reported at 6 months but no change in tear size was found on MRI.…”

Section: Partial Rotator Cuff Tearmentioning

confidence: 99%

Use of biologics in rotator cuff disorders: Current concept review

Rohman

Snow

2021

Journal of Clinical Orthopaedics and Trauma

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Poor tendon to bone healing following rotator cuff repair has led to the continued interest and investigation into biological augmentation. The biology of tendinopathy is not fully understood and consequently the availability of disease modifying therapeutic targets is limited. A ceiling of benefit has been reached by mechanical optimisation of rotator cuff repair and thus, in order to improve healing rates, a biological solution is required. This review focuses on the strategies to biologically augment rotator cuff disorders with an emphasis on rotator cuff repair. Leucocyte rich platelet rich plasma has been shown to improve healing rates without clinically relevant improvements in outcome scores. Similarly, improved healing rates have also been reported with bone marrow stimulation and in long-term follow-up with bone marrow concentrate. Extracellular matrix (ECM) and synthetic scaffolds can increase healing through mechanical and or biological augmentation. A potential third category of scaffold is bioinductive and has no mechanical support. Studies involving various scaffolds have shown promising results for augmentation of large to massive tears and is likely to be most beneficial when tendon quality is poor, however level I evidence is limited.

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Cryopreserved amniotic membrane and umbilical cord particulate matrix for partial rotator cuff tears

Cited by 22 publications

References 51 publications

A decellularized flowable placental connective tissue matrix supports cellular functions of human tenocytes in vitro

A decellularized flowable placental connective tissue matrix supports cellular functions of human tenocytes in vitro

Homologous Use of Allogeneic Umbilical Cord Tissue to Reduce Knee Pain and Improve Knee Function

Use of biologics in rotator cuff disorders: Current concept review

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