scholarly journals Editorial Commentary: When Treating Cartilage Lesions With Osseous Involvement, Biologic “Chondrofacilitation” Using Either Bone Marrow Aspirate Concentrate or Mesenchymal Stem Cells Augments Microfracture

2021 ◽  
Vol 37 (8) ◽  
pp. 2531-2532
Author(s):  
Mathew J. Hamula ◽  
Bert R. Mandelbaum
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Bone Marrow Aspirate ◽  
Cartilage Lesions ◽  
Bone Marrow Aspirate Concentrate ◽  
Editorial Commentary ◽  
Osseous Involvement

scholarly journals BMAC and Adipose-Derived MSCs Treatment for Knee Osteoarthritis: A Systematic Review

2021 ◽  
Vol 7 (04) ◽  
pp. 01-11
Author(s):  
Pooja Pithadia
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Stromal Vascular Fraction ◽  
Cochrane Library ◽  
Bone Marrow Aspirate Concentrate ◽  
Mesh Terms

Background: Knee osteoarthritis is the most common musculoskeletal progressive disorder that affects nearly 303 million people worldwide. This condition prevails in 10% males and 13% females among the elders above 60. Although there is conventional nonsurgical and surgical treatment available for knee osteoarthritis, there is a fascinating interest in bone marrow aspirate concentrate (BMAC) as well as adipose-derived mesenchymal stem cells (AD-MSC), including enzymatically treated stromal vascular fraction (SVF) and mechanically treated (microfat/nanofat) injections among physicians. Hence, this systematic review aims to determine the efficacy of BMAC and AD-MSCs (enzyme and mechanically treated) injections for knee osteoarthritis treatment. Methods: A systematic review was performed on the following data sources (PubMed, Scopus, Google Scholar, EMBASE, and Cochrane Library) published on March 31, 2021. The keywords or MeSH terms include 'Knee Osteoarthritis with 'Bone marrow aspirate concentrate' OR 'BMAC' or with 'Adipose-derived mesenchymal stem cells (AD-MSC)' or with 'Stromal vascular fraction' OR 'SVF' or 'Mechanically treated AD-MSC (mfat/nanofat)'. In addition, the retrieved articles were further reviewed to identify relevant research studies. Results: The authors reviewed and tabulated data based on the year of study, study type, therapy protocol, patient population, outcome measures, and interpretation. Among the 382 records screened, 43 studies (16 on BMAC and 27 on AD-MSCs) were included in the systematic review study. Among them, only 5 were randomized controlled trials. These selected studies demonstrated short-term positive outcomes such as improvement in knee pain and function with no adverse side effects. Moreover, researchers reported varied administration methods of BMAC or AD-MSC either as standalone or in combination with other conservative procedures such as PRP (Platelets Rich Plasma), HA (Hyaluronic acid), or surgery. Conclusions: BMAC and AD-MSC (enzymatically and mechanically treated) injections prove safer and more efficacious in patients with knee osteoarthritis for a shorter duration of 2 years. However, the available literature lacks high-quality studies with no varied clinical settings and long-term follow-up of more than two years.

scholarly journals Bone Marrow Aspirate Concentrate for Cartilage Defects of the Knee: From Bench to Bedside Evidence

Cartilage ◽  
2017 ◽  
Vol 9 (2) ◽  
pp. 161-170 ◽  
Author(s):  
Eric J. Cotter ◽  
Kevin C. Wang ◽  
Adam B. Yanke ◽  
Susan Chubinskaya
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Clinical Data ◽  
Bone Marrow Aspirate ◽  
Tissue Response ◽  
Cartilage Defects ◽  
Injection Timing ◽  
Bone Marrow Aspirate Concentrate ◽  
And Cartilage

Objective To critically evaluate the current basic science, translational, and clinical data regarding bone marrow aspirate concentrate (BMAC) in the setting of focal cartilage defects of the knee and describe clinical indications and future research questions surrounding the clinical utility of BMAC for treatment of these lesions. Design A literature search was performed using the PubMed and Ovid MEDLINE databases for studies in English (1980-2017) using keywords, including [“bone marrow aspirate” and “cartilage”], [“mesenchymal stem cells” and “cartilage”], and [“bone marrow aspirate” and “mesenchymal stem cells” and “orthopedics”]. A total of 1832 articles were reviewed by 2 independent authors and additional literature found through scanning references of cited articles. Results BMAC has demonstrated promising results in the clinical application for repair of chondral defects as an adjuvant procedure or as an independent management technique. A subcomponent of BMAC, bone marrow derived–mesenchymal stem cells (MSCs) possess the ability to differentiate into cells important for osteogenesis and chondrogenesis. Modulation of paracrine signaling is perhaps the most important function of BM-MSCs in this setting. In an effort to increase the cellular yield, authors have shown the ability to expand BM-MSCs in culture while maintaining phenotype. Conclusions Translational studies have demonstrated good clinical efficacy of BMAC both concomitant with cartilage restoration procedures, at defined time points after surgery, and as isolated injections. Early clinical data suggests BMAC may help stimulate a more robust hyaline cartilage repair tissue response. Numerous questions remain regarding BMAC usage, including cell source, cell expansion, optimal pathology, and injection timing and quantity.

scholarly journals Is Microfracture Alone Enough?

2021 ◽  
Vol 11 (16) ◽  
pp. 7309
Author(s):  
Paul-Gabriel Borodi ◽  
Octav Marius Russu ◽  
Andrei Marian Feier ◽  
Vlad Alexandru Georgeanu ◽  
Sándor-György Zuh ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Long Term Results ◽  
Cartilage Defects ◽  
Future Research ◽  
Bone Marrow Stimulation ◽  
Bone Marrow Aspirate Concentrate

The technique of microfracture (MFX) was first performed 40 years ago and served for many years as the main procedure for repairing cartilage defects. There is a need to improve microfractures because the regenerated cartilage differs from the original histological aspect; it is less hyaline and more fibrocartilaginous. In addition, and more importantly, the benefits do not persist and the long-term results are unsatisfactory. Adjunctive treatments include platelet-rich plasma (PRP), cell-free-based scaffolds, adipose-derived mesenchymal stem cells (ADSCs), and bone marrow aspirate concentrate (BMAC). The aim of this review was to provide an overview and a perspective of the available data regarding MFX and the principal adjunctive treatments from recent years and also to challenge the traditional MFX procedure. We found that cell-free scaffolds, platelet-rich plasma, and bone marrow aspirate concentrate, although they are relatively novel therapies, showed great potential and maintained their clinical benefits for longer periods of time compared to microfracture alone. As for chitosan-based therapy and adipose-derived mesenchymal stem cells, we were not able to form a definitive conclusion. We believe that the available data show promising results, and future research should be done on each topic discussed. Moreover, investigators involved in bone marrow stimulation techniques should focus on conducting prospective comparative studies, performing second-look arthroscopy, and rely on a single enhancement procedure that can be adequately compared with MFX alone.

A rapid method for obtaining mesenchymal stem cells and platelets from bone marrow aspirate

2012 ◽  
Vol 8 (6) ◽  
pp. 483-492 ◽  
Author(s):  
Barbara Dozza ◽  
Giuliana Gobbi ◽  
Enrico Lucarelli ◽  
Michela Pierini ◽  
Claudia Di Bella ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Rapid Method ◽  
Bone Marrow Aspirate
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