Stem Cells for Torn Ligaments and Sports Injuries
Stem cells for tendon tissue engineering and regeneration.
Expert Opin Biol Ther. 2010 May;10(5):689-700
Authors: Yin Z, Chen X, Chen JL, Ouyang HW
Tendon injuries are common especially in sports activities, but tendon is a unique connective tissue with poor self-repair capability. With advances in stem cell biology, tissue engineering is becoming increasingly powerful for tissue regeneration.
Stem cells with capacity of multipotency and self-renewal are an ideal cell source for tissue engineering.
PMID: 20367125 [PubMed - indexed for MEDLINE]
Repair of chronic osteochondral defects using predifferentiated mesenchymal stem cells in an ovine model.
Am J Sports Med. 2010 Sep;38(9):1857-69
Authors: Zscharnack M, Hepp P, Richter R, Aigner T, Schulz R, Somerson J, Josten C, Bader A, Marquass B
The use of mesenchymal stem cells (MSCs) to treat osteochondral defects caused by sports injuries or disease is of particular interest. However, there is a lack of studies in large-animal models examining the benefits of chondrogenic predifferentiation in vitro for repair of chronic osteochondral defects.
Innovative strategies for treatment
of soft tissue injuries in human and animal athletes.
Med Sport Sci. 2009;54:150-65
Authors: Hoffmann A, Gross G
Our aim is to review the recent progress in the management of musculoskeletal disorders. We will cover novel therapeutic approaches based on growth factors, gene therapy and cells, including stem cells, which may be combined with each other as appropriate.
We focus mainly on the treatment of soft tissue injuries - muscle, cartilage, and tendon/ligament for both human and animal athletes.
The need for innovative strategies results from the fact that despite all efforts, the current strategies for cartilage and tendon/ligament still result in the formation of functionally and biomechanically inferior tissues after injury (a phenomenon called 'repair' as opposed to proper 'regeneration'), whereas the outcome for muscle is more favorable.
Innovative approaches are urgently needed not only to enhance the outcome of conservative or surgical procedures but also to speed up the healing process from the very long disabling periods, which is of special relevance for athletes.
The roles of TGF-beta1 gene transfer on collagen formation during Achilles tendon healing.
Biochem Biophys Res Commun. 2009 May 29;383(2):235-9
Authors: Hou Y, Mao Z, Wei X, Lin L, Chen L, Wang H, Fu X, Zhang J, Yu C
Collagen content and cross-linking are believed to be major determinants of tendon structural integrity and function. The current study aimed to investigate the effects of transforming growth factor (TGF)-beta1 on the collagen content and cross-linking of Achilles tendons, and on the histological and biomechanical changes occurring during Achilles tendon healing in rabbits.
Bone marrow-derived mesenchymal stem cells (BMSCs) transfected with the TGF-beta1 gene were surgically implanted into experimentally injured Achilles tendons. Collagen proteins were identified by immunohistochemical staining and fiber bundle accumulation was revealed by Sirius red staining.
Achilles tendons treated with TGF-beta1-transfected BMSCs showed higher concentrations of collagen I protein, more rapid matrix remodeling, and larger fiber bundles.
Thus TGF-beta1 can promote mechanical strength in healing Achilles tendons by regulating collagen synthesis, cross-link formation, and matrix remodeling.
Mesenchymal stem cell-based therapy for cartilage repair: a review.
Knee Surg Sports Traumatol Arthrosc. 2009 Nov;17(11):1289-97
Authors: Koga H, Engebretsen L, Brinchmann JE, Muneta T, Sekiya I
Articular cartilage injury remains one of the major concerns in orthopaedic surgery. Mesenchymal stem cell (MSC) transplantation has been introduced to avoid some of the side effects and complications of current techniques. The purpose of this paper is to review the literature on MSC-based cell therapy for articular cartilage repair to determine if it can be an alternative treatment for cartilage injury.
MSCs retain both high proliferative potential and multipotentiality, including chondrogenic differentiation potential, and a number of successful results in transplantation of MSCs into cartilage defects have been reported in animal studies. However, the use of MSCs for cartilage repair is still at the stage of preclinical and phase I studies, and no comparative clinical studies have been reported. Therefore, it is difficult to make conclusions in human studies.
This requires randomized clinical trials to evaluate the effectiveness of cell-based cell therapy for cartilage repair.
Related Articles Sonographically Guided Knee Meniscus Injections: Feasibility, Techniques and Validation. PM R. 2017 Jan 13;: Authors: Baria MR, Sellon JL, Lueders D, Smith J Abstract BACKGROUND: There is a growing interest in the use of biologic agents such as platelet-rich plasma and mesenchymal stem/stromal cells to treat musculoskeletal injuries, including meniscal tears. Although prior research has documented the role of diagnostic ultrasound to evaluate meniscal tears, sonographically guided (SG) techniques to specifically deliver therapeutic agents into the meniscus have not been described. OBJECTIVE: To describe and validate SG injection techniques for the body and posterior horn of the medial and lateral meniscus. DESIGN: Prospective, cadaveric laboratory investigation. SETTING: Academic institution procedural skills laboratory. SUBJECTS: Five unenbalmed cadaveric knee-ankle-foot specimens from 5 donors (3 female and 2 male) ages 33-92 years (mean age 74 years) with body mass indices of 21.1-32.4 kg/m(2) (mean 24.1 kg/m(2)). METHODS: A single, experienced operator completed SG injections into the bodies and posterior horns of the medial and lateral menisci of 5 unenbalmed cadaveric knees using colored latex and a 22-gauge, 38-millimeter needle. Following injection, co-investigators dissected each specimen to assess latex distribution within the menisci and identify injury to intra-articular and peri-articular structures. MAIN OUTCOME MEASURES: Latex location within the target region of meniscus (accurate/inaccurate), and iatrogenic injury to "at risk" intra- and peri-articular structures (present/absent). RESULTS: Seventeen of 20 injections were accurate. Two of 3 inaccurate injections infiltrated the posterior horn of the medial meniscus instead of the targeted meniscal body. One inaccurate lateral meniscus injection did not contain latex despite sonographically accurate needle placement. No specimen exhibited injury to regional neurovascular structures or intra-articular hyaline cartilage. CONCLUSIONS: SG meniscus injections are feasible and can accurately and safely deliver injectates such as regenerative agents into bodies and posterior horns of the medial and lateral menisci. The role of SG intrameniscal injections in the treatment of patients with degenerative and traumatic meniscal disorders warrants further exploration. PMID: 28093371 [PubMed - as supplied by publisher]Read more...