Regenerative Medicine  Overview and Indications
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Regenerative Medicine Overview and Indications

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Regenerative Medicine Overview and Indications




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Slide1

Regenerative Medicine Overview and Indications

Brian Siegel, MD

Steamboat Springs, CO

Slide2

Biologics used for Regenerative Medicine

Platelet rich plasma

Platelet poor plasma

Human amniotic cells

Bone marrow stem cells

Adipose derived stem cells

Slide3

Slide4

Slide5

Types of PRP

High

hct

, high

wbc

, high platelet

Low

hct

, low

wbc

, high platelet

Low

hct

, low

wbc

, low platelet

Slide6

Indications for PRP injections

Areas of body with lower blood supply

Tendinopathies

Plantar Fasciitis

Sacroiliitis

Wound healing

Nerve damage

Little to no data to support PRP for discs or articular cartilage OA (by itself)

Slide7

Indications for PPP injections

Contains a variety of growth factors

Muscle tears

Joint preparation prior to stem cell injection

Volume expansion for injections

Slide8

Human Amniotic CellsAnti-inflammatory properties

Growth factors

Hyaluronic acid

Stem Cell activators

HSC’s (hematopoietic stem cells, CD34+)

Better in patients with autoimmune disease?

Slide9

Indications for Amniotic fluid injectionsTendinopathies

Joint pain associated with mild osteoarthritis

Allografts used for cartilage defects

Wound healing

Peripheral neuropathy

Slide10

Slide11

Slide12

Slide13

Bone Marrow Stem CellsContains

Mesenchymal Stem Cells MSCs

Hematopoietic Stem Cells HSCs

Endothelial progenitor Cells EPCs

Platelets

Anti-inflammatory

Immunomodulatory

Slide14

Slide15

Adipose Stem Cells

Mesenchymal Stem Cells MSCs

T regulatory cells

Macrophages

Endothelial Progenitor Cells EPCs

Stromal Vascular Fraction SVF

Slide16

Slide17

Bone Marrow Aspirate

Adipose derived cells

Slide18

Slide19

Indications for Mesenchymal Stem Cell Therapy

Knee Osteoarthritis – stage 1-4

Meniscal tears

DJD of hip, shoulder, ankle, etc.

Labral tears

Glenoid Type 1 and 2

Hip

Intervertbral

Disc and Facet Degeneration

Chondral defects

Avascular Necrosis

Slide20

Contraindications for Mesenchymal Stem Cell Therapy

Active infection

Active cancer

History of lymphoma

Certain blood thinner, i.e.

Ticlid

,

Xaralto

Major structural defect

Impaired ROM

Slide21

Complications

Transient increase in pain, resolution within 7 days

Transient increase in swelling, resolution within 14 days

Rash – secondary to adhesive, topical antibiotic or prep

No reported malignancies

Slide22

Conclusion

Biologics are safe and effective

Good treatment alternatives for chronic musculoskeletal pain

More studies are needed to determine:

Best biologic for each particular disease

Soft tissue

Cartilage

Disk

When to choose PRP, BMAC, Adipose, Amnion

Slide23