Regenerative treatments in sports and orthopedic medicine

Cover
Title
Copyright
Contents
Contributors
Preface
Share Regenerative Treatments in Sports and Orthopedic Medicine
Chapter 1: Current Concepts in the Pathophysiology of Orthopedic Conditions Affecting Treatment
	Common Musculoskeletal Disorders in Orthopedics
	Tendinopathy
		Normal Tendon Structure
		Tendon Blood Supply and Innervation
		Biomechanics
		Pathophysiology of Tendinopathy
		Cartilage Injury
		Normal Articular Anatomy
		Osteoarthritis
		Osteoarthritis Risk Factors
		Pathophysiology
		Fibrocartilage Injury
		Intervertebral Disc Injury
		Meniscal Injury
		Common Treatments Currently Used
		Surgical Management
	Other Concepts Affecting Therapy
		Smoking
		Alcohol
		Exercise
		Sleep and Metabolic Derangements
	Conclusion
	References
Chapter 2: Understanding Regenerative Medicine Terminology
	Common Regenerative Medicine Terminology
	Acknowledgments
Chapter 3: Regulatory Issues Regarding the Clinical Use of Regenerative Treatments
	The Law as It Relates to Regenerative Medicine in the United States
		Historical Basis for Federal Regulation and Oversight
		The Meaning and Proposed Application of FDA’s “Minimal Manipulation” Standard for Analyzing Product Safety and Risk
	Supporting Case Law: United States V. Regenerative Sciences, LLC
	FDA’s Current Showing of Enforcement Discretion and Its Scope
	FDA Regulatory Enforcement and the Potential Risk for Physicians
	Notes
Chapter 4: Clinical and Administrative Considerations in Performing Regenerative Procedures
	Laboratory
	Exam Rooms
	Location and Ancillary Services
	Staffing
	Administrative Considerations
		Informed Consent
		Occupational Safety and Health Administration
		Centers for Disease Control and Prevention
		Health Insurance Portability and Accountability Act
		Clinical Laboratory Improvement Amendments
		Joint Commission Standards
	Notes
Chapter 5: Regenerative Medicine in the Canine: A Translational Model
	The Use of Biologics in the Canine
	Platelet-Rich Plasma
		The Optimal PRP Product
		Platelet-Rich Plasma in the Canine
		Administration of PRP
	Stem Cell Therapy
		Stem Cell and PRP Combination Therapy
		Administration of Stem Cell Therapy
		Rehabilitation Therapy Following Stem Cell Therapy
	Hyaluronic Acid
		Hyaluronic Acid in the Canine
		Administration of Hyaluronic Acid
	Biologics for OA
	Biologics for Soft Tissue Injury
		Stem Cell Therapy for Soft Tissue Injury
		Stem Cell and PRP Combination Therapy for Soft Tissue Injury
	Commonly Treated Soft Tissue Injuries in the Canine
		Rotator Cuff Injury in the Canine
		Iliopsoas Tendinopathy
		Achilles Tendinopathy
		Cranial Cruciate Ligament Injuries
		Stifle Collateral Ligament Injuries
	Conclusion
	References
Chapter 6: Principles of Platelet-Rich Plasma and Stem Cells: From Platelets to Cytokines
	Phases of Tissue Healing Versus Pathologic Degeneration
		Tissue Regeneration and Orthobiologics
	Basics of PRP Therapy
		Preparation of PRP
		Basics of Stem Cell Therapy
		Mesenchymal Stem Cells
	Ethical Considerations
	Conclusion
	Acknowledgment
	References
Chapter 7: Scientific Evidence of Platelet-Rich Plasma for Orthopedic Conditions: Basic Science to Clinical Research and Application
	Basic Science
		Wound Healing
		Components of PRP
		Considerations for Use of PRP
	Evidence for Musculoskeletal Disorders
		Tendon
		Ligament
		Muscle
		Cartilage
		Intervertebral Disc
		Future Work
	Conclusion
	References
Chapter 8: Platelet-Rich Plasma to Enhance Orthopedic Procedures
	What is Platelet-Rich Plasma?
		Definition
		How Does PRP Work?
	Attributes of PRP Preparations
		What Platelets Concentrations Are Considered Ideal?
		White Blood Cells
		Red Blood Cells
		Activators
	Classification Systems
		Mishra’s Classification
		Dohan Ehrenfest et al. (2009)
		PAW Classification
		PRLA Classification
	Clinical Applications PRP to Enhance Orthopedic Procedures
	Rotator Cuff Disease
	Platelet-Rich Plasma Augmentation of Achilles Tendon Repair
	Anterior Cruciate Ligament Reconstruction or Repair
		Imaging Studies
		Histology
		Clinical Studies
	Platelet-Rich Plasma to Enhance Surgical Treatment of Meniscal Tears
	Platelet-Rich Plasma to Enhance Cartilage Repair
	Platelet-Rich Plasma and Knee Osteoarthritis
	Platelet-Rich Plasma to Treat Degenerative Hip Disease
	Conclusion
	References
Chapter 9: Amniotic and Umbilical Cord Products, Alpha-2 Macroglobulin, and Interleukin-1 Receptor Antagonist Protein
	Amniotic Fluid and Tissue Products
	Umbilical Cord Blood
	Interleukin-1 Receptor Antagonist Protein
	Alpha-2 Macroglobulin
	Conclusion
	References
Chapter 10: Setup and Procedures for Performing Platelet-Rich Plasma Injections
	Definition
	Biologic Healing Response
	Role of Growth Factors
	Platelet Concentration
	Role of Leukocytes and Red Blood Cells
	Classification Systems
	Preparation Methods
	Growth Factors and Preparation Protocols
	Anticoagulation
	Platelet Activation
	Preprocedure Instructions
	Equipment and Personnel
	Procedure Details
	Injection Setup
	Imaging
	Postinjection Instructions
	Post-PRP: Rehabilitation
	Conclusion
	References
Chapter 11: Basic Science and Rationale for Using Stem Cells for Orthopedic Conditions
	Defining Mesenchymal Stem Cells
	Minimal Criteria and Surface Markers
		Pericyte Origins
		Differentiation and Basic Properties
	Sources of MSCs
	Migration to Sites of Injury
	Trophic Properties
	Immunomodulation
	Culturing, Scaffolds, and Regulatory Issues
	Adherence, Integration, and Engraftment
	Future Perspectives
	Key Points
	References
Chapter 12: Harvesting Techniques of Bone Marrow and Adipose for Stem Cell Procedures
	History of BM
		Indications for BM Evaluation
		Risks of Procurement of BM Aspirate and Treatment
		Consent, Preparation, and Testing
		Contraindications to BM
	Bone Marrow Aspirate Procedure
		Anatomy
		Equipment and Procedure
		Postprocedure Care
		Equipment
		Low Pressure Lipoaspirate Technique
		Processing the Adipose Aspirate
		Complication in Liposuction Cases
		Factors Affecting Cell Harvesting: Lipoaspiration
		Peripheral Circulation Mobilization of Cells
	References
Chapter 13: Techniques for Performing Regenerative Procedures for Orthopedic Conditions
	General Joint Injection Guidelines
		Pertinent Anatomy and Pathology
		Indications for Regenerative Treatments
		Technical Considerations
	General Tendon Injection Guidelines
		Pertinent Anatomy and Pathology
		Indications for Regenerative Therapy
		Technical Considerations
	General Muscle Injection Guidelines
		Pertinent Anatomy and Pathology
		Indications for Use
		Technical Considerations
	General Bone Injection Guidelines
		Pertinent Anatomy and Pathology
		Indications for Use
		Technical Considerations
	Shoulder
		Glenohumeral Joint and Posterior Labrum
		Supraspinatus and Infraspinatus Tendons
		Proximal Biceps and Subscapularis Tendons
	Elbow
		Common Extensor Tendon and Radial Collateral Ligament Complex
		Common Flexor Tendon, Ulnar Collateral Ligament
	Wrist and Hand
		First CMC Joint
		Carpal Bones and Articulation
		Wrist Extensor Tendons
		Triangular Fibrocartilage Complex
	Hip
		Femoroacetabular Joint
		Acetabular Labrum
		Gluteus Medius, Gluteus Minimus, and Iliotibial Tract
	Knee
		Suprapatellar Recess of the Knee Joint
		Quadriceps and Patellar Tendons
		Anterior Cruciate Ligament
		Medial Meniscus and Medial Collateral Ligament
		Lateral Meniscus and Lateral Collateral Ligament
	Ankle
		Tibiotalar Joint
		Posterior Tibial Tendon
		Subtalar Joint
		ATFL, Calcaneofibular, and AITFL
		Achilles Tendon
	Foot
		Plantar Fascia
		MTP Joints
	References
Chapter 14: Physical Therapy Considerations Following Regenerative Medicine Interventions
	What is Prolotherapy?
	What is Platelet-Rich Plasma?
		Stem Cell Treatments
	Sports Medicine Consideration for Regenerative Medicine
	Stages of Healing for Acute and Chronic Conditions
		Tendon–Tenocytes
		Ligaments-Fibrocytes
		Muscle–Myoblasts
		Cartliage–Chondrocyte
		Bone–Chondrocytes/Osteoblasts
	Rehabilitation Principles
	Rehabilitation Protocols
		Tendon
		Ligaments
		Muscle
		Cartilage: Stem Cell Treatments
		Spinal Conditions
	Conclusion
	References
Index