The Placenta: Applications in Orthopaedic Sports Medicine

McIntyre, James A.; Jones, Ian A.; Danilkovich, A. V.; Ct, Vangsness

doi:10.1177/0363546517697682

Cited by 49 publications

(40 citation statements)

References 78 publications

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“…The amniotic membrane itself consists of two important cell layers where MSCs are thought to reside: the amniotic epithelial cell layer and amniotic mesenchymal layer. 6 Amniotic epithelial cells are attached to a thick basement cell layer, which itself may provide therapeutic benefit as a bioscaffold. 6 Placental tissues may be processed by cryopreservation or a freeze-drying method called lyophilization, preserving tissues to be later reconstituted at the time of administration.…”

Section: Amniotic Injectablesmentioning

confidence: 99%

“…6 Amniotic epithelial cells are attached to a thick basement cell layer, which itself may provide therapeutic benefit as a bioscaffold. 6 Placental tissues may be processed by cryopreservation or a freeze-drying method called lyophilization, preserving tissues to be later reconstituted at the time of administration. Amniotic injectables should be considered as a source of growth factors and cytokines as opposed to a viable source of MSCs.…”

Section: Amniotic Injectablesmentioning

confidence: 99%

“…Published reports support that these procedures are safe. [4][5][6][7] However, data regarding their efficacy have remained mixed.…”

Section: Introductionmentioning

confidence: 99%

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Orthobiologics for the Hip Region: A Narrative Review

McInnis

Chen

Finnoff

et al. 2020

PM&R

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Management of hip region disorders is challenging. Orthobiologic treatments including platelet rich plasma (PRP), mesenchymal stem cells, and amniotic injectables have gained popularity as promising treatments despite a lack of robust evidence for their effectiveness. We review rationale and current evidence for orthobiologics for three common hip region conditions: hip osteoarthritis, gluteal tendinopathy, and proximal hamstring tendinopathy. Overall, the current state of evidence is extremely limited for orthobiologic treatments and is predominantly relevant to PRP injections. There is currently a lack of data to support the use of mesenchymal stem cells or amniotic injectables in these conditions of the hip. the use of orthobiologics in the treatment of three common diagnoses affecting the hip region: osteoarthritis (OA), gluteal tendinopathy, and proximal hamstring tendinopathy (PHT). Methods A review was conducted of PubMed and Medline articles from January 2000 to June 2019 with search terms including hip, osteoarthritis, gluteal tendonitis, hamstring tendonitis, tendinosis, tendinopathy, platelet rich plasma, mesenchymal stem cell, amniotic stem cell, and amniotic injectables. Randomized controlled trials, case series, systematic reviews, and meta-analyses were reviewed. Only studies investigating chronic refractory tendinopathy and osteoarthritis were included. We did not include studies investigating acute muscle, myotendinous injury, acetabular labral pathology, or focal osteochondral lesion. Platelet Rich Plasma PRP is an autologous plasma concentrate containing platelets above physiologic concentrations in whole blood. Platelets are thought to initiate the healing cascade by forming a fibrin matrix, which serves as a tissue

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Section: Amniotic Injectablesmentioning

confidence: 99%

Section: Amniotic Injectablesmentioning

confidence: 99%

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Orthobiologics for the Hip Region: A Narrative Review

McInnis

Chen

Finnoff

et al. 2020

PM&R

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“…The main regenerative technologies currently being investigated in the context of sports injuriesare cell therapies [27], and specific blood derivatives on the basis of their concentration and physiological balance of healing and/or antiinflammatory factors [28]. Also, the use of placenta products is capturing attention [29]. In the context of musculoskeletal injuries, these products are often referenced as orthobiologics.…”

Section: Regenerative Treatments For Sports Impairmentmentioning

confidence: 99%

How far have biological therapies come in regenerative sports medicine?

Andı́a

Maffulli

2018

Expert Opinion on Biological Therapy

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Regular engagement in sports produces many health benefits, but also exposes to increased injury risk. The quality of medical care available is crucial not only for sports trauma but also to avoid overuse syndromes and post-traumatic degenerative conditions. Areas covered: We provide background information on some clinical needs in sport injuries and describe the main families of biological products used in clinical practice. We also discuss limitations of the current clinical experience. Expert opinion: Sport and exercise impairment affects different segments of the population with different needs. The exceptional demands of elite athletes and subsequent media coverage have created hype around regenerative therapies. Statistical evidence, whether weak (cell products) or moderate (PRPs), is not enough to drive medical decisions because of the heterogeneity of the biological products available and their application procedures. Moreover, the specific needs of the different segments of the population along with the available clinical evidence for each musculoskeletal condition should be considered in the decision-making process. There is urgent need to develop regenerative protocols combined with post-intervention rehabilitation, and gather meaningful clinical data on the safety and efficacy of these interventions in the different populations segments.

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“…According to recent studies, [13][14][15][16] Laennec is rich in bioactive substances, such as peptides and amino acids. [17][18][19][20] Recently, it has been used as a prolotherapy to treat acute tendon or ligament injury in the musculoskeletal system. 21) Therefore, in the present study, we examined the regenerative effects of Laennec in ligament using in vitro and in vivo system in an artificial ligament injury model.…”

Section: Introductionmentioning

confidence: 99%

Effects of Human Placenta Extract (Laennec) on Ligament Healing in a Rodent Model

Shin¹,

Kim

Hada

et al. 2019

Biological & Pharmaceutical Bulletin

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Rich in bioactive substances such as amino acids and peptides, Laennec (human placenta hydrolysate) has been widely used to control various types of musculoskeletal pain. However, the effects of Laennec on tendon and ligament injuries are not clearly understood. In the present study, Laennec was tested to identify its in vivo effects on ligament injury in an animal model and its in vitro effects on tendon-derived fibrocytes. A total of 99 Sprague Dawley rats were divided into the negative control (normal) group (n 11) and the ligament injury group (n 88). The ligament injury group was subdivided into normal saline-treated group, Laennec-treated group, polydeoxyribonucleotide-treated group, and 20% dextrose-treated group. Ligaments were collected at 1 week and 4 weeks after treatment. Histologic and biomechanical properties were analyzed. In vitro effects of Laennec and polydeoxyribonucleotide on fibrocytes were also analyzed. Although all other treatment groups showed increased inflammatory cells, the Laennec-treated group maintained cell counts and activated macrophage levels that were similar to the normal group. Unlike the saline-treated group and dextrose-treated group, the Laennec-treated group had low levels of degenerative changes at 4 weeks after treatment. Supportively, in vitro results showed that the Laennec-treated group had increased collagen type I, scleraxis (Scx) and tenomodulin (Tnmd) expression (p < 0.05). Our study demonstrates that Laennec treatment enhances wound healing of damaged ligament by suppressing immune responses and reducing degenerative changes of damaged ligament. In addition, we found that Laennec induces the gene expression of type I collagen, Scx and Tnmd in fibrocytes, suggesting that Laennec may facilitate regeneration of damaged ligaments. Therefore, we expect that Laennec can be a useful drug to treat injured ligament.

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The Placenta: Applications in Orthopaedic Sports Medicine

Cited by 49 publications

References 78 publications

Orthobiologics for the Hip Region: A Narrative Review

Orthobiologics for the Hip Region: A Narrative Review

How far have biological therapies come in regenerative sports medicine?

Effects of Human Placenta Extract (Laennec) on Ligament Healing in a Rodent Model

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