Platelet rich plasma for treatment of osteochondral lesions of the talus: A systematic review of clinical trials

Yausep, Oliver Emmanuel; Madhi, Imad; Trigkilidas, Dionysios

doi:10.1016/j.jor.2020.01.046

Cited by 31 publications

(23 citation statements)

References 67 publications

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“…In clinical application, PRP enhanced bone defects healing. In osteochondral defects of the talus, patients that received surgery with PRP showed greater improvements than patients with PRP therapy but without surgery [ 89 ]. Prosecka et al reported the highest volume of bone and uniform bone distribution in a collagen/hydroxyapatite/PCL scaffold modified with both PRP and autologous MSCs in rabbits.…”

Section: Discussionmentioning

confidence: 99%

Hydrogel Containing Anti-CD44-Labeled Microparticles, Guide Bone Tissue Formation in Osteochondral Defects in Rabbits

et al. 2020

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Hydrogels are suitable for osteochondral defect regeneration as they mimic the viscoelastic environment of cartilage. However, their biomechanical properties are not sufficient to withstand high mechanical forces. Therefore, we have prepared electrospun poly-ε-caprolactone-chitosan (PCL-chit) and poly(ethylene oxide)-chitosan (PEO-chit) nanofibers, and FTIR analysis confirmed successful blending of chitosan with other polymers. The biocompatibility of PCL-chit and PEO-chit scaffolds was tested; fibrochondrocytes and chondrocytes seeded on PCL-chit showed superior metabolic activity. The PCL-chit nanofibers were cryogenically grinded into microparticles (mean size of about 500 µm) and further modified by polyethylene glycol–biotin in order to bind the anti-CD44 antibody, a glycoprotein interacting with hyaluronic acid (PCL-chit-PEGb-antiCD44). The PCL-chit or PCL-chit-PEGb-antiCD44 microparticles were mixed with a composite gel (collagen/fibrin/platelet rich plasma) to improve its biomechanical properties. The storage modulus was higher in the composite gel with microparticles compared to fibrin. The Eloss of the composite gel and fibrin was higher than that of the composite gel with microparticles. The composite gel either with or without microparticles was further tested in vivo in a model of osteochondral defects in rabbits. PCL-chit-PEGb-antiCD44 significantly enhanced osteogenic regeneration, mainly by desmogenous ossification, but decreased chondrogenic differentiation in the defects. PCL-chit-PEGb showed a more homogeneous distribution of hyaline cartilage and enhanced hyaline cartilage differentiation.

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Section: Discussionmentioning

confidence: 99%

Hydrogel Containing Anti-CD44-Labeled Microparticles, Guide Bone Tissue Formation in Osteochondral Defects in Rabbits

et al. 2020

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“…Abundant preclinical evidence has demonstrated that treatment of AC lesions with PRP may result in improved chondrocyte matrix production and minimised catabolism, enhanced stem cell homing, higher differentiation of stem cells into chondrogenic phenotypes, and decreased inflammation [163]. More importantly, such beneficial effects have also been confirmed by numerous clinical studies [164,165]. Additionally, the combination of PRP treatment with OC scaffolds has already been explored in vitro [166] and in vivo [167,168].…”

Section: Growth Factor Deliverymentioning

confidence: 99%

Osteochondral Tissue Engineering: The Potential of Electrospinning and Additive Manufacturing

Gonçalves¹,

Moreira²,

Weber

et al. 2021

Pharmaceutics

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The socioeconomic impact of osteochondral (OC) damage has been increasing steadily over time in the global population, and the promise of tissue engineering in generating biomimetic tissues replicating the physiological OC environment and architecture has been falling short of its projected potential. The most recent advances in OC tissue engineering are summarised in this work, with a focus on electrospun and 3D printed biomaterials combined with stem cells and biochemical stimuli, to identify what is causing this pitfall between the bench and the patients’ bedside. Even though significant progress has been achieved in electrospinning, 3D-(bio)printing, and induced pluripotent stem cell (iPSC) technologies, it is still challenging to artificially emulate the OC interface and achieve complete regeneration of bone and cartilage tissues. Their intricate architecture and the need for tight spatiotemporal control of cellular and biochemical cues hinder the attainment of long-term functional integration of tissue-engineered constructs. Moreover, this complexity and the high variability in experimental conditions used in different studies undermine the scalability and reproducibility of prospective regenerative medicine solutions. It is clear that further development of standardised, integrative, and economically viable methods regarding scaffold production, cell selection, and additional biochemical and biomechanical stimulation is likely to be the key to accelerate the clinical translation and fill the gap in OC treatment.

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“… 69 , 70 PRP is rich in various growth factors and cytokines such as TGF-beta, platelet-derived growth factor (PDGF), insulin-like growth factor (IGF) I and II, fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) which are believed to enhance the natural healing response by promoting MSC differentiation and cartilage formation. 71 , 72 , 73 The use of PRP to treat OLTs has also been systematically reviewed and was concluded to result in significantly reduced pain and improved function in comparison with microfracture alone. 73 Despite being a promising treatment option, to date, there is limited clinical evidence for the use of PRP and an absence of a standardised preparation technique prior to application.…”

Section: Treatment and Outcomesmentioning

confidence: 99%

“… 71 , 72 , 73 The use of PRP to treat OLTs has also been systematically reviewed and was concluded to result in significantly reduced pain and improved function in comparison with microfracture alone. 73 Despite being a promising treatment option, to date, there is limited clinical evidence for the use of PRP and an absence of a standardised preparation technique prior to application. 74 …”

Section: Treatment and Outcomesmentioning

confidence: 99%

The management of talar osteochondral lesions - Current concepts

Lan

McCarthy

Hulme

et al. 2021

Journal of Arthroscopy and Joint Surgery

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Osteochondral lesions of the talus (OLTs) are a common complication following trauma, involving both the articular cartilage and the underlying subchondral bone, with variable aetiologies and often presenting with non-specific symptoms. Diagnosis of OLTs requires a combination of clinical assessment and imaging and despite many different treatment options, there is no generalised consensus regarding which option is the most effective. Left untreated, OLTs risk progressing to osteoarthritis. Acute non-displaced OLTs can be treated non-operatively. However, OLTs refractory to non-surgical care for three to six months may be suitable for surgical care. In these cases, conservative treatments are often unsuccessful, particularly for larger and more severe defects and so the majority require surgical intervention. Although bone marrow stimulation techniques remain the “gold standard” for lesions <150 mm 2 , there still requires a need for better long term clinical data and cost-benefit analyses compared with other treatment options. Biological attempts at either regenerating or replacing the articular cartilage are however demonstrating some promising results, but each with their own advantages and disadvantages. In this review, we summarise the clinical management of OLTs and present the current concepts of different treatment regimes.

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Platelet rich plasma for treatment of osteochondral lesions of the talus: A systematic review of clinical trials

Cited by 31 publications

References 67 publications

Hydrogel Containing Anti-CD44-Labeled Microparticles, Guide Bone Tissue Formation in Osteochondral Defects in Rabbits

Hydrogel Containing Anti-CD44-Labeled Microparticles, Guide Bone Tissue Formation in Osteochondral Defects in Rabbits

Osteochondral Tissue Engineering: The Potential of Electrospinning and Additive Manufacturing

The management of talar osteochondral lesions - Current concepts

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