Article

In orthopedic surgery there has been a never-ending quest to improve surgical
outcome and the patient's experience. Progression has been marked by the
refinement of surgical techniques and instruments and later by enhanced
diagnostic imaging capability, specifically magnetic resonance. Over time implant
optimization was achieved, along with the development of innovative minimally
invasive arthroscopic technical skills to leverage new versions of classic
procedures and implants to improve short-term patient morbidity and initial,
mid-term, and long-term patient outcomes. The use of regenerative and/or
biological adjuncts to aid the healing process has followed in the drive for
continual improvement, and major breakthroughs in basic science have
significantly unraveled the mechanisms of key healing and regenerative pathways.
A wide spectrum of primary and complementary regenerative treatments is becoming
increasingly available, including blood-derived preparations, growth factors,
bone marrow preparations, and stem cells. This is a new era in the application of
biologically active material, and it is transforming clinical practice by
providing effective supportive treatments either at the time of the index
procedure or during the postoperative period. Regenerative treatments are
currently in active use to enhance many areas of orthopedic surgery in an attempt
to improve success and outcome. In this review we provide a comprehensive
overview of the peer-reviewed evidence-based literature, highlighting the
clinical outcomes in humans both with preclinical data and human clinical trials
involving regenerative preparations within the areas of rotator cuff, meniscus,
ligament, and articular cartilage surgical repair.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS