Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Biologics and Tissue Healing in Orthopaedics 8 articles


The Effect of Granulocyte-colony Stimulating Factor on Rotator Cuff Healing After Injury and Repair

David Ross MD, Tristan Maerz MS, Michael Kurdziel MS, Joel Hein MD, Shashin Doshi MD, Asheesh Bedi MD, Kyle Anderson MD, Kevin Baker PhD

The failure rate of tendon-bone healing after repair of rotator cuff tears remains high. A variety of biologic- and cell-based therapies aimed at improving rotator cuff healing have been investigated, and stem cell-based techniques have become increasingly more common. However, most studies have focused on the implantation of exogenous cells, which introduces higher risk and cost. We aimed to improve rotator cuff healing by inducing endogenous stem cell mobilization with systemic administration of granulocyte-colony stimulating factor (G-CSF).

Platelet-rich Concentrates Differentially Release Growth Factors and Induce Cell Migration In Vitro

Michael O. Schär MD, Jose Diaz-Romero PhD, Sandro Kohl MD, Matthias A. Zumstein MD, Dobrila Nesic PhD

Platelet-rich concentrates are used as a source of growth factors to improve the healing process. The diverse preparation protocols and the gaps in knowledge of their biological properties complicate the interpretation of clinical results.

Platelet-rich Plasma Modulates the Secretion of Inflammatory/Angiogenic Proteins by Inflamed Tenocytes

Isabel Andia PhD, Eva Rubio-Azpeitia MSc, Nicola Maffulli MD, MS, PhD, FRCS (Orth)

Platelet-rich plasma therapies for tendinopathy appear to provide moderate pain reduction. However, the biological mechanisms behind the observed clinical effects remain poorly characterized.

Platelet-rich Plasma in Meniscal Repair: Does Augmentation Improve Surgical Outcomes?

Justin W. Griffin MD, Michael M. Hadeed MD, Brian C. Werner MD, David R. Diduch MD, Eric W. Carson MD, Mark D. Miller MD

Increased contact stresses after meniscectomy have led to an increased focus on meniscal preservation strategies to prevent articular cartilage degeneration. Platelet-rich plasma (PRP) has received attention as a promising strategy to help induce healing and has been shown to do so both in vitro and in vivo. Although PRP has been used in clinical practice for some time, to date, few clinical studies support its use in meniscal repair.

What Is the Utility of Biomarkers for Assessing the Pathophysiology of Hip Osteoarthritis? A Systematic Review

Jeffrey J. Nepple MD, Kayla M. Thomason BS, Tonya W. An BS, Marcie Harris-Hayes DPT, John C. Clohisy MD

Innovations in biologics offer great promise in the treatment of patients with orthopaedic conditions and in advancing our ability to monitor underlying disease pathophysiology. Our understanding of the pathophysiology of hip osteoarthritis (OA) has improved significantly in the last decade. Femoroacetabular impingement (FAI) and hip dysplasia are increasingly recognized and treated as forms of prearthritic hip disease, yet the inability of radiographic and MR imaging to identify patients before the onset of irreversible articular cartilage injury limits their use for early diagnosis and treatment of patients with these conditions. Molecular biomarkers, as objectively measureable indicators of the pathophysiology of hip OA, have the potential to improve diagnosis, disease staging, and prognosis of hip OA and prearthritic hip disease. Although research into molecular biomarkers of hip OA has been conducted, investigations in prearthritic hip disease have only recently begun.

What Is the Effect of Matrices on Cartilage Repair? A Systematic Review

James D. Wylie MD, Melissa K. Hartley BA, Ashley L. Kapron PhD, Stephen K. Aoki MD, Travis G. Maak MD

Articular cartilage has minimal endogenous ability to undergo repair. Multiple chondral restoration strategies have been attempted with varied results.

rhPDGF-BB Promotes Early Healing in a Rat Rotator Cuff Repair Model

David Kovacevic MD, Lawrence V. Gulotta MD, Liang Ying DVM, John R. Ehteshami MD, Xiang-Hua Deng MD, Scott A. Rodeo MD

Tendon-bone healing after rotator cuff repair occurs by fibrovascular scar tissue formation, which is weaker than a normal tendon-bone insertion site. Growth factors play a role in tissue formation and have the potential to augment soft tissue healing in the perioperative period.