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Regenerative Medicine (Main)

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Other Names


Background


Pathophysiology


Risk Factors


Terminology

  • Alpha 2 Macroglobulin
    • A major serum protease inhibitor, inhibits all classes of endoproteases[1]
    • Intra-articular injections could potentially slow cartilage damage following a traumatic knee injury by neutralizing cartilage catabolic degrading enzymes
  • Autologous Conditioned Serum
    • Aspiration of patients blood, followed by a period of incubation (conditioning), then centrifuge and injection
    • Brand names: Orthokine and Regenokine
  • Autologous Protein Solution
    • A version of LR-PRP with a higher concentration of humoral factors
  • Bone Marrow Aspiration Concentrate (BMC/BMAC)
    • A concentrate of bone marrow aspiration (BMA) containing multiple cell types, including a small number of mesenchymal stem cells (MSCs), typically created through a centrifugation process[2]
  • Cell-based medicinal product
    • Medicinal product consisting of viable cells.
    • These products may contain genetically modified human cells and can be combined with non cellular components
  • Cell therapy
    • Administration of living cells to a patient for the treatment of disease or condition
  • Cell therapy product
    • Biological product that contains or consists of substantially manipulated living cells/tissues that is administered to humans to treat, prevent, or diagnose a disease through the pharmacological, immunological, or metabolic action of its cells/tissues
  • Embryonic stem cell
    • Pluripotent cell derived from the undifferentiated inner cell mass of an embryo
  • Human Platelet Lysate
    • Growth factor-rich cell culture supplement derived from healthy donor human platelets
  • Mesenchymal Stem Cells (MSC)
    • Nonhematopoietic multipotent adult stem cell identified in multiple tissues that can differentiate into specialized stromal cells
    • Reported to be present in bone marrow, umbilical cord blood, adipose tissue, and muscle
    • Has the capability to differentiate into specialized stromal cells of skeletal tissues such as tenocytes, osteoblasts, chondrocytes, and adipocytes
    • Also referred to as mesenchymal stromal stem cells
  • Microfragmented Adipose Grafting
    • Method of harvesting MSC
    • The cells are processed without the use of enzymes or additives to concentrate the adipose-derived mesenchymal stem cells
    • Name brands: Lipogems, Nanofat
  • Orthobiologics
    • Use of biological substances to enhance biological healing of orthopedic injuries or alter the natural course of an orthopedic disease
  • Perinatal products
    • Perinatal-derived allogeneic biomaterials donated and recovered from healthy individuals
    • E.g. Dehydrated Amniotic Tissue Injections, Umbilical Cord, Blood, Wharton's Jelly, etc.
  • Platelet Rich Plasma (PRP)
    • Blood plasma enriched in platelets, which contains cytokines and growth factors in higher concentrations than in blood plasma
  • Pluripotent
    • Capable of developing into any of the 3 primary germ cell layers and therefore all cells of the adult body, but not extraembryonic tissue (ie, placenta)
  • Prolotherapy
    • Hyperosmolar dextrose injection which triggers the inflammatory cascade and healing.
    • The treatment targets fibroosseous junctions or entheses and well as intra-articular applications[3]
  • Regenerative Medicine
    • Interdisciplinary therapeutic approach that aims to repair, replace, regenerate, and/or rejuvenate lost, damaged, or diseased cells, tissues, or organs to restore or establish normal form and function.
  • Somatic cell
    • Any cell that makes up a multicellular organism that is not a germinal, reproductive, or undifferentiated cell
  • Stem cell
    • Undifferentiated cell of multicellular organisms with the ability to carry out both self-renewal and asymmetric cell division and to provide cells that can differentiate into other cell types
  • Stromal cells
    • Nonhematopoietic connective tissue cell that indirectly influences and supports blood cell growth, typically derived from bone marrow.
  • Stromal Vascular Fraction
    • Adipose derived collection of heterogeneous cells and components, most notably: MSC, HSC, Treg Cells, Pericyte-EC, mast-cells, complex microvascular beds (fibroblasts, WBC, dendritic cells, intra-adventitial smooth muscular-like cells, etc.), and extracellular matrix
  • Viscosupplement
    • Injectable HA-based products that reduce pain through shock absorption and decreased inflammation by arachidonic acid and IL1 inhibition[4]

Clinical Features


Evaluation


Classification


Management

Nonoperative

Operative


Return to Play


Complications


See Also


References


  1. Luan Y, Kong L, Howell DR, Ilalov K, Fajardo M, Bai XH, et al. Inhibition of ADAMTS-7 and ADAMTS-12 degradation of cartilage oligomeric matrix protein by alpha-2-macroglobulin. Osteoarthritis & Cartilage. 2008;16(11):1413–20.
  2. Finnoff, Jonathan T. DO*; Awan, Tariq M. DO†; et al. American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine, Clinical Journal of Sport Medicine: November 2021 - Volume 31 - Issue 6 - p 530-541
  3. Hauser RA. Journal of prolotherapy international editorial board consensus statement on the use of prolotherapy for musculskeletal pain. J Prolotherapy. 2011;3:744–764.
  4. Tehranzadeh J, Booya F, Root J. Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol. 2005;46:288–296.
Created by:
John Kiel on 17 October 2019 01:23:22
Authors:
Last edited:
30 October 2021 16:25:26