Interventional orthopedics in pain medicine practice

Centeno, Christopher J.; Williams, Christopher J.; Hyzy, Matthew

doi:10.1053/j.trap.2016.09.005

Cited by 5 publications

(13 citation statements)

References 43 publications

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“…Orthopedic regenerative medicine is a rapidly growing medical specialty that uses both autologous and allogeneic orthobiologics to assist in tissue healing [1]. Autologous bone marrow stands as a common source of progenitor cells, and one predominant orthobiologic, bone marrow aspirate concentrate (BMAC), has been safely used to treat a variety of orthopedic conditions [2À4].…”

Section: Introductionmentioning

confidence: 99%

Cryopreserved bone marrow aspirate concentrate as a cell source for the colony-forming unit fibroblast assay

Berger¹,

Aune²,

Centeno

et al. 2020

Cytotherapy

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The prevalence of connective tissue progenitor cells within a cell-based therapy is often quantified using the colony-forming unit fibroblast (CFU-F) assay. The present study investigates the feasibility of using cryopreserved bone marrow aspirate concentrate (BMAC) as an alternative cell source to fresh BMAC for CFU-F quantification. Methods: Freshly prepared and corresponding cryopreserved BMAC samples from patients receiving autologous cell therapy (n = 98) were analyzed using the CFU-F assay for comparison. Cultures were established by directly plating BMAC at low cell densities and maintained for a 2-week growth period. Colonies were enumerated to determine CFU-F frequency, and a subset of cultures was imaged and analyzed to quantify colony area and density. Results: A nonlinear relationship was observed between plating density and CFU-F frequency over a wide range in plating densities (~30-fold). Cryopreserved BMAC yielded recoverable (77 § 23%) and viable (73 § 9%) nucleated cells upon thawing. After cryopreservation, CFU-F frequencies were found to be significantly lower (56.6 § 34.8 vs. 50.3 § 31.7 colonies per million nucleated cells). Yet the number of CFU-F in fresh and cryopreserved BMAC were strongly correlated (r = 0.87) and had similar area and densities. Further, moderate correlations were observed between the number of CFU-F and nucleated cells, and both the mean colony area and density were negatively correlated with patient age. Notably, no relationship was found between CFU-F frequency and age, regardless of whether fresh or cryopreserved BMAC was used. Conclusions: Freshly prepared and cryopreserved BMAC yielded correlated results when analyzed using the CFU-F assay. Our findings support the cryogenic storage of patient BMAC samples for retrospective CFU-F analyses, offering a potential alternative for characterizing BMAC and furthering our understanding of progenitor cells in relation to clinical outcome.

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Section: Introductionmentioning

confidence: 99%

Cryopreserved bone marrow aspirate concentrate as a cell source for the colony-forming unit fibroblast assay

Berger¹,

Aune²,

Centeno

et al. 2020

Cytotherapy

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“…These procedures may use chemicals (drugs), physical methods (radiofrequency), or biological products (platelet-rich plasma or concentrates of medicinal mesenchymal cells from bone marrow or fat), alone or in combination. [53][54][55][56][57] Blocks and infiltrations can be diagnostic or therapeutic. The advent of better imaging methods and the rise of ultrasonography (with no radiation and easily accessible) as a diagnostic tool to assist orthopedists in medical practice resulted in the potential performance of many of these blocks on an outpatient basis, helping pain control and bridging conservative and surgical treatment.…”

Section: Interventional Pain Treatmentmentioning

confidence: 99%

“…In addition, in some cases, they can postpone and avoid surgeries. [53][54][55][56][57] The blocks can target the most varied structures of the human body, including the bursa, muscles, and joint sensory nerve endings and branches, such as the genicular branches of the knee in patients with osteoarthritis. [53][54][55][56][57]…”

Section: Interventional Pain Treatmentmentioning

confidence: 99%

“…Nestes procedimentos podem ser utilizados meios químicos (drogas), meios físicos (radiofrequência), e/ou produtos biológicos (plasma rico em plaquetas ou concentrados de células medicinais mesenquimais da medula óssea ou da gordura). [53][54][55][56][57] Os bloqueios e infiltrações podem ser diagnósticos ou terapêuticos. Com o advento de melhores métodos de imagem e com a ascensão da ultrassonografia (sem uso de radiação e de fácil acesso) como ferramenta diagnóstica e auxiliar do ortopedista na prática médica muitos desses bloqueios podem ser feitos de maneira ambulatorial, auxiliando o paciente no controle da dor, na ponte entre o tratamento conservador e cirúrgico.…”

Section: Tratamento Intervencionista Da Dorunclassified

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Atualização no manejo da dor musculoesquelética

Tsai,

Kobayashi,

Liu

et al. 2024

Rev Bras Ortop (Sao Paulo)

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ResumoA dor é a queixa mais comum recebida pelo ortopedista no ambulatório e/ou emergência. Inúmeras publicações relatam o manejo inadequado tanto da dor aguda quanto da dor crônica pelos profissionais da saúde. O objetivo desse artigo de atualização é trazer informações sobre a dor musculoesquelética, sua classificação, avaliação, diagnóstico e abordagem terapêutica multimodal para cada situação. Desta maneira, nas dores agudas seu controle adequado possibilita um trabalho de reabilitação mais precoce, bem como diminui os índices de cronificação da dor. Nas dores crônicas sua abordagem além da diminuição de sua intensidade, visa também melhorar a qualidade de vida. Atualmente alguns procedimentos estão sendo cada vez mais utilizados com auxílio de aparato de imagem com objetivo diagnóstico e terapêutico.

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“…For bone marrow lesions and AVN in particular, the proposed therapeutic mechanism of action involves the repopulation of the subchondral microenvironment with healthier mesenchymal signaling cells (MSCs) transferred via concentrated bone marrow aspirated from a different anatomic location [14]. Over time, procedural techniques for minimally invasive percutaneous applications of these therapies have spawned the novel field of interventional orthopedics to serve as a bridge between traditional conservative care and surgery [16]. We present a case of secondary ON of the proximal tibia distal to the weight-bearing surface, as well as in the distal femur, which was successfully treated with a combination of intraosseous BMC, demineralized bone matrix (DBM), and PRP injection.…”

Section: Introductionmentioning

confidence: 99%

Atraumatic Medullary Osteonecrosis of the Tibia and Femur Treated With Intraosseous Orthobiologics

Street¹,

Jerome²,

Williams³

2021

Cureus

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Osteonecrosis (ON) is a painful condition involving bony cell death with resultant architectural collapse. This report discusses the case of a 50-year-old Caucasian female who presented to an outpatient musculoskeletal clinic with severe chronic left knee pain. She had a history of ulcerative colitis and resultant chronic corticosteroid exposure with subsequent development of knee ON. She was treated with an intraosseous autologous bone marrow concentrate (BMC), demineralized bone matrix (DBM), and plateletrich plasma (PRP) injection. At 11 months post-injection, she demonstrated a significant improvement in pain scores, mobility, activity, and decreased narcotic use. Intraosseous orthobiologic injection for the treatment of knee ON is a promising procedure with a reasonable safety profile that warrants further study as an alternative to surgical intervention.

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Interventional orthopedics in pain medicine practice

Cited by 5 publications

References 43 publications

Cryopreserved bone marrow aspirate concentrate as a cell source for the colony-forming unit fibroblast assay

Cryopreserved bone marrow aspirate concentrate as a cell source for the colony-forming unit fibroblast assay

Atualização no manejo da dor musculoesquelética

Atraumatic Medullary Osteonecrosis of the Tibia and Femur Treated With Intraosseous Orthobiologics

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