Orthobiologics-Today
Vol 3 | Issue 2 | July-Dec 2018 | Page 30-35 | Ramesh K Sen, Manuj Aggarwal.
Authors: Ramesh K Sen [1], Manuj Aggarwal [1].
[1] Institute of orthopaedics, Max hospital Mohali, India
Address of Correspondence
Dr. Ramesh Sen,
Institute of orthopaedics, Max hospital Mohali, India
Email: senramesh@rediffmail.com
Abstract
Orthobiologics is a newer science that has biologic-based therapies for treatment of various hip, knee, ankle and shoulder pathologies. It involve biological sources which promote and accelerate bone and soft tissue healing and based on theoretical advantages in focal chondral defect, osteoarthritis, AVN hip, plantar fasciitis and various tendinopathies. Strong evidence which support the use of biologic agent such as hyaluronic acid, platelet rich plasma bone marrow aspirate concentrate, largely remain absent from the literature. This article review the existing literature on most commonly employed biologic agent for the different knee, hip, and ankle pathologies. There was a lack of clinical evidence for various treatment strategies; therefore we suggest that there is a need for comparative studies in future.
Keywords: Orthobiologics, Hyaluronic acid, platelet rich plasma, Bone marrow aspirate concentrate; Adipose derived stem cells, Osteoarthritis
References
1. Acosta-OlivoC,Elizondo-RodriguezJ,Lopez-CavazosR,VilchezCavazos F, Simental-Mendia M, Mendoza-Lemus O. Plantar fasciitis-a comparison of treatment with intralesional steroids versus platelet-rich plasma arandomized,blindedstudy .JAmPodiatrMed Assoc. 2017;107(6):490–6.
2. Ahmed M, Reffat SA, Hassan A, Eskander F. Platelet-rich plasma for the treatment of clean diabetic foot ulcers. Ann Vasc Surg. 2017;38:206–11.
3. Alsousou J, Thompson M, Hulley P, Noble A, Willett K (2009) The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: A review of the literature. J Bone Joint Surg Br 91(8): 987-996.
4. Aufiero D, Vincent H, Sampson S Bodor M (2015) Regenerative Injection Treatment in the Spine: Review and Case Series with Platelet Rich Plasma. J stem cell Res Rev reports 1(4).
5. Bannuru, R., et al., Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis–meta-analysis. Osteoarthritis and Cartilage, 2011. 19(6): p. 611-619.
6. Bannuru, R.R., et al. Relative efficacy of hyaluronic acid in comparison with NSAIDs for knee osteoarthritis: A systematic review and meta-analysis. in Seminars in arthritis and rheumatism. 2013. Elsevier.
7. Bastos Filho R, Lermontov S, Borojevic R, Schott PC, Gameiro VS, Granjeiro JM. Cell therapy of pseudarthrosis. Acta Ortop Bras Gianakos AL et al .cBMA in orthopaedics 506 June 18, 2017|Volume 8|Issue 6|WJO |www.wjgnet.com 2012; 20: 270-273 .
8. BoesenAP, HansenR,BoesenMI,MalliarasP,LangbergH.Effect of high-volume injection, platelet-rich plasma, and sham treatment in chronic mid portion Achilles tendinopathy :a randomized double blinded prospective study. Am J Sports Med. 2017;45(9):2034–43.
9. Buda R, Vannini F, Castagnini F, Cavallo M, Ruffilli A, Ramponi L, Pagliazzi G, Giannini S. Regenerative treatment in osteochondral lesions of the talus: autologous chondrocyte implantation versus onestep bone marrow derived cells transplantation. Int Orthop 2015; 39: 893-900.
10. Buda R, Vannini F, Cavallo M, Baldassarri M, Luciani D, Mazzotti A, Pungetti C, Olivieri A, Giannini S. One-step arthroscopic technique for the treatment of osteochondral lesions of the knee with bonemarrow-derived cells: three years results. MusculoskeletSurg 2013; 97: 145-151.
11. Campbell K A, Saltzman B M, Mascarenhas R, Khair M M, Verma N N, Bach B R, Jr., Cole B J. Does intra-articular platelet-rich plasma injection provide clinically superior outcomes compared with other therapies in the treatment of knee osteoarthritis? A systematic review of overlapping metaanalyses. Arthroscopy 2015; 31 (10): 2036–45.
12. Caplan AI. Adult mesenchymal stem cells for tissue engineering versus regenerative medicine. J Cell Physiol 2007; 213: 341-347.
13. Castricini R, Longo UG, De Benedetto M, PanfoliN, Pirani P, Zini R, Maffulli N, Denaro V: Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial. Am J Sports Med 2011, 39:258-265.
14. Centeno C, Pitts J, Al-Sayegh H, Freeman M. Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. Biomed Res Int 2014; 2014: 370621 .
15. Centeno CJ, Al-Sayegh H, Bashir J, Goodyear S, Freeman MD. A dose response analysis of a specific bone marrow concentrate treatment protocol for knee osteoarthritis. BMC MusculoskeletDisord 2015; 16: 258.
16. Cervellin M, de Girolamo L, Bait C, Denti M, Volpi P. Autologous plateletrich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: A randomized, controlled clinical study. Knee Surg Sports TraumatolArthrosc 2012; 20 (1): 114–20.
17. Colen, S., et al., Hyaluronic acid in the treatment of knee osteoarthritis: a systematic review and meta-analysis with emphasis on the efficacy of different products. BioDrugs, 2012. 26(4): p. 257-68.
18. Desai P, Hasan SM, Zambrana L, Hegde V, Saleh A, Cohn MR, Lane JM. Bone Mesenchymal Stem Cells with Growth Factors Successfully Treat Nonunions and Delayed Unions. HSS J 2015; 11: 104-111 .
19. Enea D, Cecconi S, Calcagno S, Busilacchi A, Manzotti S, Gigante A. One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate. A pilot study. Knee 2015; 22: 30-35.
20. Everts PA, Devilee RJ, Brown Mahoney C, Eeftinc k-Schattenkerk M, Box HA,Knape JT, van Zundert A: Platelet gel and fi brin sealant reduce allogeneic blood transfusions in total knee arthroplasty. Acta AnaesthesiolScand 2006, 50:593-599.
21. Everts PA, Devilee RJ, Brown Mahoney C, van ErpA, Oosterbos CJ, Stellenboom M, Knape JT, van Zundert A: Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome. A prospective randomized double-blind study. Eur Surg Res 2008, 40:203-210.
22. Filardo G, Kon E, Buda R, Timoncini A, Di Martino A ,Cenacchi A, Fornasari PM, Giannini S, Marcacci M: Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports TraumatolArthrosc 2010, 19:528-535.
23. Filardo G, Kon E, Roffi A, Di Matteo B, Merli ML (2015) Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports TraumatolArthrosc 23(9): 2459-2474.
24. Filardo, G., et al., Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskeletal Disorders, 2012. 13(1): p. 229.
25. Fukawa T, Yamaguchi S, Akatsu Y, Yamamoto Y, Akagi R, Sasho T. Safety and efficacy of intra-articular injection of platelet-rich plasma in patients with ankle osteoarthritis. Foot Ankle Int. 2017;38(6):596–604.
26. Gangji V, De Maertelaer V, Hauzeur JP. Autologous bone marrow cell implantation in the treatment of non-traumatic osteonecrosis of the femoral head: five year follow-up of a prospective controlled study. Bone 2011; 49: 1005–9.
27. Gardner MJ, Demetrakopoulos D, Klepchick PR, Mo oar PA: The efficacy of autologous platelet gel in pain control and blood loss in total knee arthroplasty. An analysis of the haemoglobin, narcotic requirement and range of motion. Int Orthop 2007, 31:309-313.
28. Garnavos C, Mouzopoulos G, Morakis E. Fixed intramedullary nailing and percutaneous autologous concentrated bone-marrow grafting can promote bone healing in humeral-shaft fractures with delayed union. Injury 2010; 41: 563-567.
29. Giannini S, Buda R, Cavallo M, Ruffilli A, Cenacchi A, Cavallo C, Vannini F. Cartilage repair evolution in post-traumatic osteochondral lesions of the talus: from open field autologous chondrocyte to bonemarrow-derived cells transplantation. Injury 2010; 41: 1196-1203.
30. Gobbi A, Karnatzikos G, Scotti C, Mahajan V, Mazzucco L, Grigolo B. One-Step Cartilage Repair with Bone Marrow Aspirate Concentrated Cells and Collagen Matrix in Full-Thickness Knee Cartilage Lesions: Results at 2-Year Follow-up. Cartilage 2011; 2: 286-299.
31. Gobbi A, Whyte GP. One-Stage Cartilage Repair Using a Hyaluronic Acid-Based Scaffold With Activated Bone Marrow-Derived Mesenchymal Stem Cells Compared With Microfracture: Five-Year Follow-up. Am J Sports Med 2016; 44: 2846-2854.
32. Gormeli G, Karakaplan M, Gormeli CA, Sarikaya B, Elmali N, ErsoyY.Clinicaleffectsofplatelet-richplasmaandhyaluronicacid as an additional therapy for talar osteochondral lesions treated with microfracture surgery: a prospective randomized clinical trial. Foot Ankle Int. 2015;36(8):891–900.
33. Gosens T, Peerbooms JC, van Laar W, den Oudsten BL: Ongoing positive eff ect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 2011, 39:1200-1208.
34. Guadilla J, Fiz N, Andia I, Sanchez M. Arthroscopic management and platelet-rich plasma therapy for avascular necrosis of the hip. Knee Surg Sports TraumatolArthrosc 2012; 20: 393–8.
35. Haleem AM, Singergy AA, Sabry D, Atta HM, Rashed LA, Chu CR, El Shewy MT, Azzam A, Abdel Aziz MT. The Clinical Use of Human Culture-Expanded Autologous Bone Marrow Mesenchymal Stem Cells Transplanted on Platelet-Rich Fibrin Glue in the Treatment of Articular Cartilage Defects: A Pilot Study and Preliminary Results. Cartilage 2010; 1: 253-261.
36. Hechtman KS, Uribe JW, Botto-vanDemden A, Kiebzak GM: Platelet-rich plasma injection reduces pain in patients with recalcitrant epicondylitis. Orthopedics 2011, 34:92.
37. Hernigou P, FlouzatLachaniette CH, Delambre J, Zilber S, Duffiet P, Chevallier N, Rouard H. Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study. Int Orthop 2014; 38: 1811-1818.
38. Hernigou P, Poignard A, Zilber S, Rouard H. Cell therapy of hip osteonecrosis with autologous bone marrow grafting. Indian J Orthop 2009; 43: 40–5.
39. Hung BP, Hutton DL, Kozielski KL, Bishop CJ, Naved B, et al. (2015) Platelet-Derived Growth Factor BB Enhances Osteogenesis of AdiposeDerived But Not Bone Marrow-Derived Mesenchymal Stromal/Stem Cells. Stem Cells 33(9): 2773-2784.
40. Jo CH, Lee YG, Shin WH, Kim H, Chai JW, et al. (2014) Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells 32: 1254-1266.
41. Kane JM, Costanzo JA, Raikin SM. The efficacy of platelet-rich plasma for incision healing after total ankle replacement using the agility total ankle replacement system. Foot Ankle Int. 2016;37(4): 373–7.
42. Koh YG, Jo SB, Kwon OR, Suh DS, Lee SW, et al. (2013) Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy 29: 748-755.
43. Krogh TP, Ellingsen T, Christensen R, Jensen P, Fredberg U. Ultrasound-guided injection therapy of Achilles tendinopathy with platelet-rich plasma or saline: a randomized, blinded, placebocontrolled trial. Am J Sports Med. 2016;44(8):1990–7.
44. Krych AJ, Nawabi DH, Farshad-Amacker NA, Jones KJ, Maak TG, Potter HG, Williams RJ. Bone Marrow Concentrate Improves Early Cartilage Phase Maturation of a Scaffold Plug in the Knee: A Comparative Magnetic Resonance Imaging Analysis to PlateletRich Plasma and Control. Am J Sports Med 2016; 44: 91-98 .
45. Kumar S ,Jain SK, Suprashant K, , Yadav A, Kearns SR. Comparison of plantar fasciitis injected with platelet-rich plasma vs corticosteroids. Foot Ankle Int. 2018;39(7):780–6.
46. Martinez-Zapata MJ, Marti-Carvajal AJ, Sola I, Exposito JA, Bolibar I, Rodriguez L et al. Autologous platelet-rich plasma for treating chronic wounds. The Cochrane Database Syst Rev 2016(5):Cd006899.
47. Matthew R. Kyle, J.D., Kyle Swartout and Richard R. Kyle, M.D. Orthobiologics: Early Adopters are Innovating the Regenerative Medicine Industry with Clinical Results. World stem cell summit •detroit, mi • october 4-6, 2010.
48. Mazzocca AD, McCarthy MB, Chowaniec DM, Cote MP, Arciero RA, Drissi H. Rapid isolation of human stem cells (connective tissue progenitor cells) from the proximal humerus during arthroscopic rotator cuff surgery. Am J Sports Med 2010; 38: 1438-1447.
49. Mei-DanO,CarmontMR,LaverL,MannG,MaffulliN,NyskaM. Platelet-rich plasma or hyaluronate in the management of osteochondral lesions of the talus. Am J Sports Med. 2012;40(3): 534–41.
50. Mishra AK, Skrepnik NV, Edwards SG, Jones GL, Sampson S, et al. (2014) Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sport Med 42(2): 463-471.
51. Murray M M, Palmer M, Abreu E, Spindler K P, Zurakowski D, Fleming B C. Platelet–rich plasma alone is not sufficient to enhance suture repair of the ACL in skeletally immature animals: An in vivo study. J Orthop Res 2009; 27 (5): 639–45.
52. Nin J R, Gasque G M, Azcarate A V, Beola J D, Gonzalez M H. Has platelet-rich plasma any role in anterior cruciate ligament allograft healing? Arthroscopy 2009; 25 (11): 1206–13.
53. Park SH, Sim WY, Min BH, Yang SS, Khademhosseini A, et al. (2012) Chip-based comparison of the osteogenesis of human bone marrow- and adipose tissue-derived mesenchymal stem cells under mechanical stimulation. PLoS One 7(9): e46689.
54. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A (2013) Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sport Med 41(2): 356-364.
55. Radice F, Yanez R, Gutierrez V, Rosales J, Pinedo M, Coda S. Comparison of magnetic resonance imaging fi ndings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy 2010; 26 (1): 50–7.
56. Randelli P, Arrigoni P, Ragone V, Aliprandi A, Cabitza P: Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg 2011, 20:518-528.
57. Redmond JM, Gupta A, Stake CE, et al. Clinical results of hip arthroscopy for labral tears: a comparison between intraoperative platelet-rich plasma and bupivacaine injection. Arthroscopy 2014; 31: 445–53.
58. Repetto I, Biti B, Cerruti P, Trentini R, Felli L. Conservative treatment of ankle osteoarthritis: can platelet-rich plasma effectively postpone surgery? J Foot Ankle Surg. 2017;56(2):362–5. Evaluated 20 patients with symptomatic ankle OA after four weekly PRP injections. At an average follow-up of 17.7 months, the authors found significant improvements in pain, function, and patient satisfaction.
59. RhaDW, Park GY, Kim YK, Kim MT, Lee SC (2013) Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial. Clin Rehabil 27(2): 113-122.
60. Rodriguez AM, Elabd, C Amri EZ, Ailhaud G, Dani C (2005) The human adipose tissue is a source of multipotent stem cells. Biochimie 87(1): 125-128.
61. Sampson S, Botto-van Bemden A, Aufiero D (2013) Autologous bone marrow concentrate: review and application of a novel intra-articular orthobiologic for cartilage disease. Phys Sport 41(3): 7-18.
62. Sampson S, Gerhardt M, Mandelbaum B (2008) Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med 1(3-4): 165-174.
63. Sánchez M, Anitua E, Azofra J, AndíaI, Padilla S, Mujika I: Comparison of surgically repaired Achilles tendon tears using platelet-rich fi brin matrices. Am J Sports Med 2007, 35:245-251.
64. Schepull T, Kvist J, Norrman H, TrinksM, Berlin G, Aspenberg P: Autologous platelets have no eff ect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med 2011, 39:38-47. 40.
65. Sen RK, Tripathy SK, Aggarwal S, et al. Early results of core decompression and autologous bone marrow mononuclear cells instillation in femoral head osteonecrosis: a randomized control study. J Arthroplasty 2012; 27: 679–86.
66. Shapiro SA, Kazmerchak SE, Heckman MG, Zubair AC, O’Connor MI. A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis. Am J Sports Med 2017; 45: 82-90.
67. Sheth U, Simunovic N, Klein G, Fu F, Ein horn TA, Schemitsch E, Ayeni OR, Bhandari M: Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am 2012, 94:298-307.
68. Stein BE, Stroh DA, Schon LC. Outcomes of acute Achilles tendon rupture repair with bone marrow aspirate concentrate augmentation. Int Orthop 2015; 39: 901-905 [PMID: 25795246 DOI: 10.1007/ s00264-015-2725-7].
69. Steven Sampson, Hunter Vincent, Mary A Ambach and Edwin Amirianfar.Orthobiologics: Where are we Now?Nov Tech Arthritis Bone Res 2(1): NTAB.MS.ID.555576 (2017).
70. Tolbert G, Roy D, Walker V (2013) Ultrasound Guided Dextrose Prolotherapy and Platelet Rich Plasma Therapy in Chronic Low Back Pain: Three Case Reports. Int J Phys Med Rehabil 1: 149.
71. Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cusc ó X, Garcia-Balletbó M: Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term eff ects on function and quality of life. Arch Orthop Trauma Surg 2011, 131:311-317.
72. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, et al. (2001) Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng 7(2): 211-228.
How to Cite this article: Sen RK, Aggarwal M. Orthobiologics-Today. Journal of Clinical Orthopaedics Jan-June 2018; 3(2):30-35. |