Clinical use of stem cells in orthopaedics part 7

Stem cell 2

 

The two most common sources of adult stem cells for clinical application in orthopaedics are bone marrow and adipose tissue. Both  bone marrow aspirate and linoaspirate contain  different cell fractions. When bone marrow aspirate is centrifuged, bone marrow aspirate concentrate can be obtained from buffy-coat layer which contains mononuclear cells including very low percentage of mesenchymal stem cells. When lipoaspirate is treated by enzymes and undergoes differential centrifugation, fat and mature adipocytes in the upper layer are separated. The bottom layer is stromal vascular fraction that contains low percentage of mesenchymal stem cells. When bone marrow aspirate concentrate and stromal vascular fraction are put into a monolayer culture on plastic dishes and passaged, cells that have characteristics of mesenchymal stem cells can be isolated.

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Clinical use of stem cells in orthopaedics part 6

Stem cell 2

 

As the  defect of articular cartilage is not amenable to conventional procedures such as microfacture, it can be a good candidate for regenerative therapy with stem cell implantation. More diffuse damage of articular cartilage, seen in osteoarthritis, may also become a target of stem cell therapy because the current treatment modalities do not offer a regenerative option for patients. Other candidates for stem cell treatment are degenerative tendon disorders, including advanced rotator cuff tears, which are not successfully treated by repair techniques.

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Clinical use of stem cells in orthopaedics part 6

Stem cell 2

 

As the  defect of articular cartilage is not amenable to conventional procedures such as microfacture, it can be a good candidate for regenerative therapy with stem cell implantation. More diffuse damage of articular cartilage, seen in osteoarthritis, may also become a target of stem cell therapy because the current treatment modalities do not offer a regenerative option for patients. Other candidates for stem cell treatment are degenerative tendon disorders, including advanced rotator cuff tears, which are not successfully treated by repair techniques.

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Clinical use of stem cells in orthopaedics part 5

Stem cell 2

 

Osteonecrosis of the femoral head, which causes the collapse of femoral head and secondary osteoarthritis of the hip joint, leads to premature total hip arthroplasty in young patients. Nonunion of long bone still often presents a dilemma in achieving a bony union. Stem cell treatment may provide an innovative therapy for these lesions. Unlike bone, which is self-regenerating tissue, articular cartilage has limited potential for self-regeneration, and damage to articular cartilage has limited potential for self-regeneration, and damage to articular cartilage eventually leads to the development and progression of osteoarthritis.

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Clinical use of stem cells in orthopaedics part 4

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Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. In the orthopaedic field, diseases which current treatment modalities do not offer satisfactory, efficient or durable results for have been  targets of stem cell treatment. While complete regeneration usually occurs after bone injury, critical size defects of long bone requires either harvesting  a large portion of autograft with significant morbidity or allograft implantation that is associated with several complications.

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Clinical use of stem cells in orthopaedics part 3

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Orthopaedic medicine has traditionally benifited from innovations in other fields of science. Development of metal and chemical engineering in the early 20th century contributed to current orthopaedic practice, as various implants based on newly developed biomaterials were devised and applied to patients. Recent advances in regenerative medicine have opened a new horizon in orthopaedics and may in future shift the paradigm in clinical practice. Diseases currently managed by surgical treatment may be more effectively and more economically treated by less-invasive procedures, such as simple injection of cells.

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Clinical use of stem cells in orthopaedics part 2

Stem cell 2

 

To date, the literature supporting stem cell-based therapies comprises  mostly case reports or case series. Therefore, high-quality evidence, including from randomised clinical trials, is necessary to define the role of cell-based therapies in the treatment of musculoskeletal disorders.  It is imperative that clinicians who adopt  stem cell treatments in their practices possess a good understanding of the natural course of the disease. It is also highly recommended that treating  physicians do not thrust aside the concomitant use of established measures until stem cell therapy is evidently proved worthy in terms of efficacy and cost.

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