Biological Therapies in Regenerative Sports Medicine

Regenerative medicine seeks to harness the potential of cell biology for tissue replacement therapies, which will restore lost tissue functionality. Controlling and enhancing tissue healing is not just a matter of cells, but also of molecules and mechanical forces. We first describe the main biologi...

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Bibliographic Details
Published in:Sports medicine (Auckland) 2017-05, Vol.47 (5), p.807-828
Main Authors: Andia, Isabel, Maffulli, Nicola
Format: Article
Language:English
Subjects:
Anterior Cruciate Ligament
Arthritis
Biological Therapy - methods
Bone healing
Bone marrow
Clinical outcomes
Conditioning
Fibroblasts
Heterogeneity
Histology
Homeostasis
Humans
Immunotherapy
Implantation
Knee
Lesions
Medicine
Medicine & Public Health
Meniscus
Mesenchymal Stromal Cells
Mesenchyme
NMR
Nuclear magnetic resonance
Osteoarthritis
Plasma
Platelet-Rich Plasma
Regeneration
Regenerative medicine
Review Article
Skin
Sports injuries
Sports Medicine
Stem cells
Tendon Injuries - therapy
Tendons
Tissue engineering
Treatment Outcome
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Summary:Regenerative medicine seeks to harness the potential of cell biology for tissue replacement therapies, which will restore lost tissue functionality. Controlling and enhancing tissue healing is not just a matter of cells, but also of molecules and mechanical forces. We first describe the main biological technologies to boost musculoskeletal healing, including bone marrow and subcutaneous fat-derived regenerative products, as well as platelet-rich plasma and conditioned media. We provide some information describing possible mechanisms of action. We performed a literature search up to January 2016 searching for clinical outcomes following the use of cell therapies for sports conditions, tendons, and joints. The safety and efficacy of cell therapies for tendon conditions was examined in nine studies involving undifferentiated and differentiated (skin fibroblasts, tenocytes) cells. A total of 54 studies investigated the effects of mesenchymal stem-cell (MSC) products for joint conditions including anterior cruciate ligament, meniscus, and chondral lesions as well as osteoarthritis. In 22 studies, cellular products were injected intra-articularly, whereas in 32 studies MSC products were implanted during surgical/arthroscopic procedures. The heterogeneity of clinical conditions, cellular products, and approaches for delivery/implantation make comparability difficult. MSC products appear safe in the short- and mid-term, but studies with a long follow-up are scarce. Although the current number of randomized clinical studies is low, stem-cell products may have therapeutic potential. However, these regenerative technologies still need to be optimized.
ISSN:0112-1642
1179-2035
DOI:10.1007/s40279-016-0620-z