Objective The use of perinatal-derived tissues and mesenchymal stromal cells (MSCs) as alternative treatment options to corticosteroid and hyaluronic acid injections has been gaining popularity. However, their ability to attenuate osteoarthritic (OA) symptoms while also slowing the progression of the disease remains controversial. Thus, the objective of this article is to summarize the results from both preclinical and clinical studies evaluating the efficacy of perinatal-derived tissue allografts and MSCs for the treatment of OA. Design A comprehensive literature search was conducted on databases including Pubmed, ScienceDirect, and Google Scholar beginning in March 2020 for both preclinical and clinical studies evaluating perinatal-derived tissues and MSCs in OA. Eighteen studies met the inclusion criteria and were used for this review. Results Both animal models and early human clinical trials demonstrated that perinatal tissues could reduce joint inflammation and pain as well as improve range of motion and function in OA. Perinatal tissue–derived MSCs in animal studies have shown the potential to support chondrocyte proliferation while also decreasing inflammatory gene and protein expression. Limited clinical results suggest perinatal tissue–derived MSC sources may also be a viable alternative or adjunct to hyaluronic acid in reducing pain and symptoms in an arthritic joint. Conclusions Perinatal tissue–derived allografts and MSCs have promise as potential therapeutics for mitigating OA progression. However, further research is warranted to fully define the therapeutic mechanism(s) of action and safety of these biological therapies.
Recent advances in headgear design research have sought to inform athletes’ safety related decisions by ranking headgear systems according to impact performance. These rankings have provided athletes with greater agency in their safety-related decisions. Despite these improvements, little quantitative information exists to compare faceguard performance. Using validated structural stiffness finite element models, this study sought to develop a parametric design approach that could be consistently applied to faceguards of different qualitative categories and of different helmet-compatible series. The methods presented in this study detail the objective measurement techniques and parameters of interest used to fully define three common American football faceguards. The results of this study indicate an ability to define parameters consistently for faceguards of different qualitative categories and of different helmet-compatible series. The high degree of correlation between mass and structural stiffness indicates expected model performance – providing increased confidence in results. Intuitively, the greatest effect on mass and structural stiffness was the size of the diameter of the main bars. Increases in mass were achieved with minimal changes in structural stiffness. Conversely, increases in structural stiffness were achieved with minimal changes in mass. These results have implications for manufacturers as some faceguards, such as those classified as “overbuilt,” are banned – in part – for their weight. Future work should continue to compare manufacturers’ original designs and investigate other metrics to further quantify performance and safety for athletes. This tool may be used to improve new faceguard designs by comparing new models to faceguards allowed for use.
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