Nonoperative and Operative Soft-Tissue and Cartilage Regeneration and Orthopaedic Biologics of the Knee: An Orthoregeneration Network (ON) Foundation Review

Knapik, Derrick M.; Evuarherhe, Aghogho; Frank, Rachel M.; Steinwachs, Matthias; Rodeo, Scott A.; Mumme, Marcus; Cole, Brian J.

doi:10.1016/j.arthro.2021.04.002

Cited by 16 publications

(5 citation statements)

References 143 publications

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“…The meniscus joint capsule area has an abundant blood supply and strong healing ability and can be sutured and repaired. Liu et al reported that only fresh wound treatment could achieve a good curative effect for stable meniscus synovial tears [22]. However, many studies have shown that medial meniscus instability and wear with medial femoral condyle cartilage reduce the possibility of spontaneous healing and lead to meniscus and cartilage damage progression [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Effects of two suture methods under arthroscopy on isolated occult medial meniscocapsular separation

Hu¹,

Xiao²

2023

Open J Clin Med Case Rep

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Section: Discussionmentioning

confidence: 99%

Effects of two suture methods under arthroscopy on isolated occult medial meniscocapsular separation

Hu¹,

Xiao²

2023

Open J Clin Med Case Rep

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“…Similarly, picking the right cells for the job may also be critical as MSC from different sources can exhibit different properties even though they can have a similar phenotype, as discussed in [ 123 , 124 ]. Thus, the right cells in the right environment at the right time are needed are discussed in [ 202 , 203 , 204 ], and there is likely a need for a more “precision medicine” approach as “one size does not fit all” [ 202 ].…”

Section: Discussionmentioning

confidence: 99%

Creating an Optimal In Vivo Environment to Enhance Outcomes Using Cell Therapy to Repair/Regenerate Injured Tissues of the Musculoskeletal System

Hart

Nakamura

2022

Biomedicines

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Following most injuries to a musculoskeletal tissue which function in unique mechanical environments, an inflammatory response occurs to facilitate endogenous repair. This is a process that usually yields functionally inferior scar tissue. In the case of such injuries occurring in adults, the injury environment no longer expresses the anabolic processes that contributed to growth and maturation. An injury can also contribute to the development of a degenerative process, such as osteoarthritis. Over the past several years, researchers have attempted to use cellular therapies to enhance the repair and regeneration of injured tissues, including Platelet-rich Plasma and mesenchymal stem/medicinal signaling cells (MSC) from a variety of tissue sources, either as free MSC or incorporated into tissue engineered constructs, to facilitate regeneration of such damaged tissues. The use of free MSC can sometimes affect pain symptoms associated with conditions such as OA, but regeneration of damaged tissues has been challenging, particularly as some of these tissues have very complex structures. Therefore, implanting MSC or engineered constructs into an inflammatory environment in an adult may compromise the potential of the cells to facilitate regeneration, and neutralizing the inflammatory environment and enhancing the anabolic environment may be required for MSC-based interventions to fulfill their potential. Thus, success may depend on first eliminating negative influences (e.g., inflammation) in an environment, and secondly, implanting optimally cultured MSC or tissue engineered constructs into an anabolic environment to achieve the best outcomes. Furthermore, such interventions should be considered early rather than later on in a disease process, at a time when sufficient endogenous cells remain to serve as a template for repair and regeneration. This review discusses how the interface between inflammation and cell-based regeneration of damaged tissues may be at odds, and outlines approaches to improve outcomes. In addition, other variables that could contribute to the success of cell therapies are discussed. Thus, there may be a need to adopt a Precision Medicine approach to optimize tissue repair and regeneration following injury to these important tissues.

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“…Olivier did not find a significantly higher cell yield with the multiple-site technique than with the single-site technique, but only 6 patients were included 13 . Inconsistent results regarding the clinical outcome in stem cell publications in general and differences in cell count between the different studies may be explained by the heterogeneity of bone marrow harvesting techniques 26 . Recent publications demand precise guidelines for the techniques used 4 , 11 , 26 , 27 .…”

Section: Introductionmentioning

confidence: 99%

“…Inconsistent results regarding the clinical outcome in stem cell publications in general and differences in cell count between the different studies may be explained by the heterogeneity of bone marrow harvesting techniques 26 . Recent publications demand precise guidelines for the techniques used 4 , 11 , 26 , 27 . However, little is known about how to do this correctly.…”

Section: Introductionmentioning

confidence: 99%

Reorientation technique has benefits in bone marrow aspiration of stem cells

Pabinger

Dammerer

Lothaller

et al. 2022

Sci Rep

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We treated patients with osteoarthritis of the knee using injections of bone marrow aspirate concentrate (stem cell therapy). Since multiple controversial harvesting methods using different sites, needles, volumes and techniques have been described, we aimed to compare those methods. Four different harvesting sites at the iliac crest, three different types of needles, three different types of volumes and two different harvesting techniques were compared in 48 bone marrow aspirations. The conventional technique (Group 1) was compared with a reorientation technique (Group 2). The number of leucocytes and CD34 + cells and the viability in bone marrow aspirate (BMA) were analysed with a CytoFLEX Flow Cytometer. The reorientation technique showed significantly higher cell counts than the conventional technique in all parameters. Leucocytes per nl increased from 5 ± 2 to 12 ± 4 (p < .001), and CD 34 + cells per μl increased from 40 ± 40 to 140 ± 98 (p = .003). There was no difference between anterior and posterior harvesting at the iliac crest or between use of a thick and use of a thin needle. Use of the reorientation technique, compared to employing the conventional technique, has a significant advantage since the number of leucocytes and CD34 + cells can be tripled. For the use of bone marrow aspirate in the case of arthritis, it might therefore be a future option to harvest a maximum cell yield through the new reorientation technique and to omit centrifugation. However, the clinical relevance of these findings remains the subject of future studies.Level of Evidence: Level I.Clinical relevance: Enhanced technique of BMA for knee surgeons to ensure the maximum cell yield for stem cell therapy in regenerative medicine.

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Nonoperative and Operative Soft-Tissue and Cartilage Regeneration and Orthopaedic Biologics of the Knee: An Orthoregeneration Network (ON) Foundation Review

Cited by 16 publications

References 143 publications

Effects of two suture methods under arthroscopy on isolated occult medial meniscocapsular separation

Effects of two suture methods under arthroscopy on isolated occult medial meniscocapsular separation

Creating an Optimal In Vivo Environment to Enhance Outcomes Using Cell Therapy to Repair/Regenerate Injured Tissues of the Musculoskeletal System

Reorientation technique has benefits in bone marrow aspiration of stem cells

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