Abstract:
Orthoregeneration is defined as a solution for orthopaedic conditions that harnesses the benefits of biology to improve healing, reduce pain, improve function, and, optimally, provide an environment for tissue regeneration. Options include drugs, surgical intervention, scaffolds, biologics as a product of cells, and physical and electromagnetic stimuli. The goal of regenerative medicine is to enhance the healing of tissue after musculoskeletal injuries as both isolated treatment and adjunct to surgical management, using novel therapies to improve recovery and outcomes. Various orthopaedic biologics (orthobiologics) have been investigated for the treatment of pathology involving the elbow and upper extremity, including the tendons (lateral epicondylitis, medial epicondylitis, biceps tendonitis, triceps tendonitis), articular cartilage (osteoarthritis, osteochondral lesions), and bone (fractures, nonunions, avascular necrosis, osteonecrosis). Promising and established treatment modalities include hyaluronic acid; botulinum toxin; corticosteroids; leukocyte-rich and leukocyte-poor platelet-rich plasma; autologous blood; bone marrow aspirate comprising mesenchymal stromal cells (alternatively termed medicinal signaling cells and frequently mesenchymal stem cells [MSCs]) and bone marrow aspirate concentrate; MSCs harvested from adipose and skin (dermis) sources; vascularized bone grafts; bone morphogenic protein scaffold made from osteoinductive and conductive β-tricalcium phosphate and poly-ε-caprolactone with hydrogels, human MSCs, and matrix metalloproteinases; and collagen sponge. Autologous blood preparations such as autologous blood injections and platelet-rich plasma show positive outcomes for nonresponsive tendinopathy. In addition, cellular therapies such as tissue-derived tenocyte-like cells and MSCs show a promising ability to regulate degenerative processes by modulating tissue response to inflammation and preventing continuous degradation and support tissue restoration.
摘要:
矫形术被定义为骨科疾病的解决方案,利用生物学的好处来改善愈合,减轻疼痛,改善功能,和最佳的,为组织再生提供环境。选择包括药物,手术干预,脚手架,生物制品作为细胞的产物,物理和电磁刺激。再生医学的目标是增强肌肉骨骼损伤后组织的愈合,作为隔离治疗和手术治疗的辅助手段。使用新疗法来改善恢复和结果。已经研究了各种骨科生物制剂(直视生物学),用于治疗涉及肘部和上肢的病理,包括肌腱(外上髁炎,内上髁炎,二头肌肌腱炎,肱三头肌肌腱炎),关节软骨(骨关节炎,骨软骨损伤),和骨头(骨折,非工会,缺血性坏死,骨坏死)。有希望和已建立的治疗方式包括透明质酸(HA);肉毒杆菌毒素;皮质类固醇;富含白细胞和缺乏白细胞的富含血小板的血浆(PRP);自体血;包含间充质基质细胞(也称为药物信号细胞,通常称为间充质干细胞)的骨髓抽吸物(BMA)和BMA浓缩物(BMAC);从皮肤和皮肤(真皮)来源收获的MSC;来自三聚钙血管内的脂肪凝胶(PCP-人类MSC,和基质金属蛋白酶(MMPs);和胶原海绵。自体血液制剂,如自体血液注射和富含血小板的血浆显示出无反应性肌腱病的阳性结果。此外,细胞疗法如组织来源的肌腱细胞样细胞和MSC显示出通过调节组织对炎症的反应和防止持续降解和支持组织恢复来调节变性过程的有希望的能力。