Damages of Neuromuscular System After Mechanical-Induced Limb Ischemia (Experimental Study)

Visnyk Ortopedii Travmatologii Protezuvannia ◽

10.37647/0132-2486-2021-109-2-58-62 ◽

2021 ◽

pp. 58-62

Author(s):

A.T. Pidlisetskyi

Keyword(s):

Bone Marrow ◽

Adipose Tissue ◽

Bone Marrow Aspirate ◽

Platelet Rich Plasma ◽

Limb Ischemia ◽

Scar Tissue ◽

Comparison Groups ◽

Superficial Muscle ◽

Muscle Groups ◽

Tissue Fraction

Relevance. Traumatic and ischemic injury of the limbs is accompanied by damage of the skeletal muscles and peripheral nerves of the limbs. The dynamics and consequences of ischemic lesions remain poorly understood and need to be corrected. Objective: using quantitative morphological and sonographic methods, to study the dynamics of skeletal muscle damage of the limb after traumatically induced ischemia with and without the injection of platelet-rich plasma, bone marrow aspirate, and adipose tissue fraction. Materials and Methods. In 3 experiments, rabbits were modeled with 6-hour limb ischemia by applying an elastic tourniquet. After compartment syndrome detection, based on the assessment of subfascial pressure, cell suspensions were injected into the leg muscles. Sonographic and histological examination of the muscles was performed on days 5, 15, and 30. The results of sonography and morphometry were evaluated by statistical methods. Results. The developed model of ischemia consists of 6-hour immobilization of the limb, on тwhich medical elastic tourniquets were imposing. The action of the tourniquets causes high subfascial pressure and necrosis of the superficial muscle groups of the lower third of the thigh and lower leg. According to sonography, the δ-entropy of damaged tissues on day 5 is reduced relative to the intact limb, as in the case of administration of bone marrow aspirate cells. On days 15 and 30, sonography showed no difference between the comparison groups. The dynamics of morphological features of limb tissue damage consist of necrosis of superficial muscle groups, atrophy in the middle layers, and almost intact deep muscle groups. Necrosis was replaced by scar tissue, the density of which increases 11-14 times, and does not differ in the period 5-30 days. The administration of platelet plasma, bone marrow aspirate, and adipose tissue fraction did not change the dynamics of fibrotic changes in ischemic damaged muscles. Muscle atrophy is accompanied by activation of endogenous repair of single muscle fibers, which tended to intensify after injection of bone marrow aspirate. The sciatic nerve of the injured limb was not structurally damaged according to the deep topography, while the nerves of the tibia develop degenerative changes from the 15th day.

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Autologous Biologic Treatment with Fat, Bone Marrow Aspirate and Platelet Rich Plasma Is an Effective Alternative to Total Knee Arthroplasty for Patients with Moderate Knee Arthrosis

Medicines ◽

10.3390/medicines7060037 ◽

2020 ◽

Vol 7 (6) ◽

pp. 37 ◽

Cited By ~ 1

Author(s):

Chadwick Prodromos ◽

Susan Finkle

Keyword(s):

Bone Marrow ◽

Total Knee Arthroplasty ◽

Adipose Tissue ◽

Knee Arthroplasty ◽

Bone Marrow Aspirate ◽

Platelet Rich Plasma ◽

Post Treatment ◽

Knee Oa ◽

Total Knee

Background: Osteoarthrosis (OA) of the knee afflicts millions worldwide. Total Knee Arthroplasty (TKA) is common, but associated with substantial cost and morbidity. Prior studies of intra-articular injection of fat, bone marrow aspirate (BMA), and platelet rich plasma (PRP) have shown clinical benefit. We hypothesized that injection of autologous adipose tissue, BMA, and PRP would provide significant benefit for patients with moderate knee OA resulting in avoidance of total knee arthroplasty (TKA) in most, with discontinuance of NSAIDs and other drugs. Methods: 42 TKA candidate patients (47 knees) with moderate (Kellgren-Lawrence 2 and 3) knee OA who had failed conservative treatment had autologous adipose tissue, BMA, and PRP injection as an alternative to TKA in office using only local anesthetic. Patients had discontinuance of all nonsteroidal anti-inflammatory medicines (NSAIDs) and other analgesics, except acetaminophen, prior to treatment. Patients were evaluated with Knee injury and Osteoarthritis Outcome Score Physical Shortform (KOOS-PS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Single Assessment Numeric Evaluation (SANE) prior to treatment, and at 6 months, 1, and 2 years after treatment. Results: Follow up exceeded 80% at all time points. There were no significant adverse events. TKA was avoided in 97% at one and 86% at two years after treatment. Mean SANE, KOOS-PS, and WOMAC scores significantly improved at 6 months, 1, and 2 years post-treatment. WOMAC and SANE scores were higher at two versus one year post-treatment. Conclusions: Combined fat, BMA, and PRP injection is a safe and effective treatment for moderate knee OA, with reliable avoidance of TKA and possible continued improvement at two year follow-up.

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Comparative analysis of mouse bone marrow and adipose tissue mesenchymal stem cells for critical limb ischemia cell therapy

Stem Cell Research & Therapy ◽

10.1186/s13287-020-02110-x ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Pegah Nammian ◽

Seyedeh-Leili Asadi-Yousefabad ◽

Sajad Daneshi ◽

Mohammad Hasan Sheikhha ◽

Seyed Mohammad Bagher Tabei ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Mesenchymal Stem Cells ◽

Adipose Tissue ◽

Cell Therapy ◽

Femoral Artery ◽

Critical Limb Ischemia ◽

Limb Ischemia

Abstract Introduction Critical limb ischemia (CLI) is the most advanced form of peripheral arterial disease (PAD) characterized by ischemic rest pain and non-healing ulcers. Currently, the standard therapy for CLI is the surgical reconstruction and endovascular therapy or limb amputation for patients with no treatment options. Neovasculogenesis induced by mesenchymal stem cells (MSCs) therapy is a promising approach to improve CLI. Owing to their angiogenic and immunomodulatory potential, MSCs are perfect candidates for the treatment of CLI. The purpose of this study was to determine and compare the in vitro and in vivo effects of allogeneic bone marrow mesenchymal stem cells (BM-MSCs) and adipose tissue mesenchymal stem cells (AT-MSCs) on CLI treatment. Methods For the first step, BM-MSCs and AT-MSCs were isolated and characterized for the characteristic MSC phenotypes. Then, femoral artery ligation and total excision of the femoral artery were performed on C57BL/6 mice to create a CLI model. The cells were evaluated for their in vitro and in vivo biological characteristics for CLI cell therapy. In order to determine these characteristics, the following tests were performed: morphology, flow cytometry, differentiation to osteocyte and adipocyte, wound healing assay, and behavioral tests including Tarlov, Ischemia, Modified ischemia, Function and the grade of limb necrosis scores, donor cell survival assay, and histological analysis. Results Our cellular and functional tests indicated that during 28 days after cell transplantation, BM-MSCs had a great effect on endothelial cell migration, muscle restructure, functional improvements, and neovascularization in ischemic tissues compared with AT-MSCs and control groups. Conclusions Allogeneic BM-MSC transplantation resulted in a more effective recovery from critical limb ischemia compared to AT-MSCs transplantation. In fact, BM-MSC transplantation could be considered as a promising therapy for diseases with insufficient angiogenesis including hindlimb ischemia.

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