Basic Science of Allograft Orthobiologics.

Orthobiologic procedures are based on altering the microenvironment of musculoskeletal tissues to induce an anti-inflammatory effect and reduce pain, promote healing of these tissues, or provide mechanical support. Allograft tissues have these inherent qualities and can be used as such. This could provide patients whose own autologous tissues may be compromised or have contraindications to harvesting an alternative to treat their orthopedic conditions.

Basic Science of Autologous Orthobiologics: Part 2. Mesenchymal Stem Cells.

In recent years, autologous biological preparations have emerged as a growing area of medical innovation in interventional orthopedical procedures and surgical interventions. These cellular therapies are often referred to as orthobiologics and are derived from patient's own tissues, like blood, bone marrow, and adipose tissue to prepare platelet-rich plasma (PRP), bone marrow concentrate (BMC), and adipose tissue concentrate (ATC), respectively. In this article, we emphasize and discuss the physiologic variability of autologous prepared BMC and ATC for the delivery of mesenchymal stem cells to support tissue repair processes.

Ultrasound Assessment of the Superior Capsular Reconstruction With Dermal Allograft: An Evaluation of Graft Thickness and Vascularity.

Purpose: To assess postoperative changes in the thickness of the dermal allograft of the superior capsular reconstruction (SCR) and to evaluate the graft for the presence of intrasubstance pulsatile vessels.

Methods: A retrospective chart review was conducted to identify SCR patients who had ultrasound evaluations between May 2014 and February 2019. Data were collected and stratified based on time from surgery into 2 groups: 0 to 12 months and past the 12-month follow-up.

Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic Fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison.

Background: In vivo amniotic fluid is known to contain a population of mesenchymal stem cells (MSCs) and growth factors and has been shown to assist in healing when used as an adjunct in procedures across multiple medical specialties. It is unclear whether amniotic fluid products (AFPs) contain MSCs and, if so, whether the cells remain viable after processing.

Purpose: To determine whether MSCs, growth factors, and hyaluronan are present in commercially available AFPs.

Superior Capsular Reconstruction: Clinical Outcomes After Minimum 2-Year Follow-Up.

Superior capsular reconstruction (SCR) is performed to reduce the pain and disability caused by irreparable supraspinatus rotator cuff tears (RCTs). In this article, we discuss 9 cases of irreparable rotator cuff tears managed with arthroscopic SCR with dermal allograft. At minimum 2-year follow-up (mean, 32.

A Guide to Ultrasound of the Shoulder, Part 3: Interventional and Procedural Uses.

Ultrasound is an extremely useful diagnostic tool for physicians, but recent advances have found that ultrasound's greatest utility is in interventional and procedural uses. Numerous studies have demonstrated a significant improvement in outcome and patient satisfaction when using ultrasound guidance for injections. Newer techniques are emerging to use ultrasound as an aid to surgery and interventional procedures.

A Guide to Ultrasound of the Shoulder, Part 2: The Diagnostic Evaluation.

Ultrasound is becoming an increasingly accessible modality for its easy and accurate evaluation of shoulder pathology. In Part 1 of our series (Am J Orthop. 2016;45(3):176-182), we showed how musculoskeletal ultrasound can be properly coded and reimbursed and can be as effective in evaluating the shoulder as magnetic resonance imaging, yet more economical.

The emerging use of platelet-rich plasma in musculoskeletal medicine.

Platelet-rich plasma (PRP) is one of many new developments within the expanding field of regenerative medicine. Specialists in areas such as orthopedics, physical medicine and rehabilitation, and rheumatology have been exploring the benefits of this novel therapy. Although PRP therapy remains controversial and has minimal clinical trial support, the use of orthobiologics such as PRP continues to advance as patients seek nonsurgical approaches to acute and chronic musculoskeletal injury and disease.