Biologic Orthopedics Journal <p style="margin: 0px; line-height: 115%;"><span style="margin: 0px; line-height: 115%; font-family: 'Garamond',serif; font-size: 14pt;">The Biologic Orthopedics Journal is being launched as a new online resource of evidence-based research and analysis, along with thoughtful discussion and commentary related to approaches to orthopedic biologics, their use and their promotion. The Journal will provide free and open access to scholarly work, education and discussion to meet the needs of practitioners, health workers, researchers, scientists and policy makers. The journal will be managed by the Biologic Orthopedics Journal Association, which will be responsible for administering the process of article submissions, review, and publication along with the supporting complements, a website and digital platform to empower readers of the journal and connect them to critical resources.</span></p> <p style="margin: 0px; line-height: 115%;"><span style="margin: 0px; line-height: 115%; font-family: 'Garamond',serif; font-size: 14pt;">&nbsp;</span></p> <p style="margin: 0px; line-height: 115%;"><span style="margin: 0px; line-height: 115%; font-family: 'Garamond',serif; font-size: 14pt;">The Journal articulates and disseminates new science and clinical research for advancing the scholarship and practice of regenerative medicine in the field of orthopedics and to provide evidence-based best practices.<span style="margin: 0px;">&nbsp; </span>The journal also increases world-wide exposure to the innovations, experiences and perspectives of practitioners working in the field. Article submissions are encouraged from throughout the world, and be subject to peer review. As such, this journal serves as a reputable and authoritative resource to help influence clinical practice, research funding, policy, and operational decisions regarding biologics in orthopedics.&nbsp;</span></p> en-US (Scott Bryant) (Scott Bryant) Wed, 15 Apr 2020 13:00:29 +0000 OJS 60 Regeneration of Full-Thickness Supraspinatus Rotator Cuff Tendon Tear after Treatment with Autologous Mesenchymal Stem Cells <p>Rotator cuff tear (RCT) is primarily a disease of middle-aged and older patients. Observational data es-timated linear increment in the frequency of RCT over time due to the degenerative process. However, a good proportion of tears in older patients are asymptomatic and do not require any intervention. Sport and non-sport Injuries can contribute to RCTs. Many RCTs can be treated non-surgically with anti-inflammatory medication, steroid injections, and physical therapy for symptomatic relief and to restore shoulder strength and function. Rotator cuff tendon tears have limited ability to heal on their own and most often surgical repair is recommended in people failing non-operative therapy. The recovery time after surgery can be a lengthy process. There are no conclusive data to support the routine use of biologic therapy like mesenchymal stem cells (MSCs) or platelet-rich plasma (PRP) in the treatment of symptomatic RCTs. Herein we report a full-thickness supraspinatus tear (SST) in an elderly patient’s shoulder following three injuries. The tear was confirmed by ultrasound scan (USS) and magnetic resonance imaging (MRI) with SST of 9 mm in length and 13 mm in width which was unresponsive to anti-inflammatory medicines, rehabilitation and steroid injections. The subject, however, did have a definitive clinical and radiological response to a single therapeutic injection using autologous adipose tissue-derived MSCs combined with PRP, the injections were performed by ultrasound guidance into the subacromial bursa, supraspinatus tendon and tendon insertion respectively. After five months an USS showed some healing of the SST. Eight months post-MSC therapy the subject had significant improvement in symptoms, and dramatic improvement of the Disability of the Arm, Shoulder and Hand (DASH) score from baseline of 88.3 prior to the therapy to 16.3 at the final visit. Follow-up MRI scan revealed complete healing of the SST indicating the possible successful outcome of<br />MSC therapy as an alternative non-surgical treatment.</p> Hassan Mubark Copyright (c) 2020 Biologic Orthopedics Journal Wed, 02 Sep 2020 00:00:00 +0000 Hope, Hype, Hurdles & Future Perspective for PRP, PRP versus Hyaluronic Acid Injection in Osteoarthritis of Knee: A Review Article. <p class="Default"><strong>Background</strong><br>Comparative studies of platelet-rich plasma (PRP) and hyaluronic acid show variable results.</p> <p class="Default"><strong>Purpose</strong><br>A review was conducted to understand the current role of PRP and its efficacy versus hyaluronic acid in osteoarthritis (OA) of the knee joint.</p> <p class="Default"><strong>Methods</strong><br>Out of 170 identified studies, 14 studies involving 1575 patients with 637 males and 938 females were selected based on PRISMA flow chart guidelines and were analyzed for the study.</p> <p class="Default"><strong>Results</strong><br>A standard PRP regimen consisting of 2–3 intra-articular injections (IA) of 4–6 mL of leucocyte poor PRP at 1–2 weekly intervals provides a better result than HA during the first 3–6 months, and which may continue up to one year. PRP and HA may have synergistic effect; pain and swelling are the two most com-mon complications with PRP, the incidence is more with leucocyte rich PRP (LP-PRP) and intra-osseous PRP treatment.<br>Conclusion<br>PRP provides hope and is more effective than hyaluronic acid in pain relief and improving the quality of life in mild to moderate osteoarthritis of the knee joint. However, hype, that is effective in all, irrespective of grades of OA, mal-aligned or stiff knee, ligamentous laxity, and can avoid joint replacement is a big hindrance in establishing it as a preferred treatment in OA knee. The author follows the above-mentioned PRP regimen; and recommends to combine leucocyte poor PRP with HA for IA injections &amp; with LP-PRP injections along with the two most common painful points (medial collateral ligament, pesanisernius) in a highly painful OA knee. PRP may not address extra-articular causes of knee pain (mal-alignment, muscle wasting, tendinosis), should be corrected for optimum outcome. Contact sports, running, exercises putting pressure on knee and NSAID should be avoided during PRP treatment. Also, more randomized controlled trials are required to further standardize the PRP preparation, administration, injection interval &amp; proper documentation of efficacy and complications in the regenerative registry.</p> Ashok Kumar, Anikait Ghosh Kadamb, Krish Ghosh Kadamb Copyright (c) 2020 Biologic Orthopedics Journal Wed, 15 Apr 2020 00:00:00 +0000 Chemical Profile and Clinical Efficacy of Micro-Fragmented Adipose Tissue in the Treatment of Knee Osteoarthritis <p style="text-align: justify;">Intra-articular injections of adipose-derived mesenchymal stromal cells (AD-MSCs) have emerged as a regenerative therapy to combat the progression of knee osteoarthritis (OA). These multipotent cells have been shown to alter the inflammatory processes inside the knee joint at the cellular level, thus creating a treatment option that both modifies the underlying causes of OA and benefits those who are not surgical candidates. This review article serves to present the following objectives: (1) to summarize the techniques used to harvest AD-MSCs, via micro-fragmentation and enzymatic processing, (2) to characterize the chemical profile and immunomodulatory role of these cells from the current literature, (3) to comprehensively review the clinical efficacy of these interventions, from animal to human studies that investigate the safety concerns, biomolecular changes, and key functional outcomes, and (4) to present areas of future research needed to optimize these interventional regenerative therapies in the treatment of knee OA.</p> Jack Haberl, Nathan Hogaboom, Gerard Malanga Copyright (c) 2020 Haberl et al Tue, 23 Jun 2020 00:00:00 +0000