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过去、当前及未来的介入性骨生物治疗技术及其与再生康复的关系:临床述评

PAST, CURRENT AND FUTURE INTERVENTIONAL ORTHOBIOLOGICS TECHNIQUES AND HOW THEY RELATE TO REGENERATIVE REHABILITATION: A CLINICAL COMMENTARY.

作者信息

Centeno Christopher J, Pastoriza Sarah M

机构信息

Centeno-Schultz Clinic, Broomfield, CO, USA.

出版信息

Int J Sports Phys Ther. 2020 Apr;15(2):301-325.

Abstract

UNLABELLED

Interventional orthobiologics is changing the landscape of orthopedic medicine. Various methods exist for treatment of many different musculoskeletal pathologies. Candidacy for such injections remains a debated topic, and current research is underway for stratifying the patients that would be most successful for certain techniques. Described in this commentary are the various methods of interventional orthobiologic techniques available such as: prolotherapy, platelet rich plasma (PRP), mesenchymal stromal cells (MSCs), culture-expanded MSCs and amniotic-based products. Here we review the healing cascade and how this relates to the application of the various injectates and rehabilitation protocols. In conclusion, there exists orthobiologic techniques for the healing of a multitude of musculoskeletal ailments, from ligamentous instabilities/tears, tendon derangements and osteoarthritis, however candidacy grades continue to be an area for discussion as to which type of treatment is the most beneficial, and which rehabilitation protocols are required. More randomized controlled trials and comparative analyses are needed for direct correlative conclusions for which interventional orthobiologic treatment and rehabilitation protocol is best after each respective treatment.

LEVEL OF EVIDENCE

摘要

未标注

介入性骨生物治疗正在改变骨医学的格局。治疗多种不同肌肉骨骼疾病存在多种方法。此类注射的候选资格仍是一个有争议的话题,目前正在进行研究以对某些技术最可能成功的患者进行分层。本评论描述了可用的各种介入性骨生物治疗技术方法,如:注射疗法、富血小板血浆(PRP)、间充质基质细胞(MSC)、培养扩增的MSC和基于羊膜的产品。在此我们回顾愈合级联以及这与各种注射剂和康复方案的应用有何关系。总之,存在用于治疗多种肌肉骨骼疾病的骨生物治疗技术,从韧带不稳定/撕裂、肌腱紊乱到骨关节炎,但关于哪种类型的治疗最有益以及需要哪种康复方案,候选资格分级仍是一个有待讨论的领域。需要更多的随机对照试验和比较分析,以便得出关于每种相应治疗后哪种介入性骨生物治疗和康复方案最佳的直接相关结论。

证据水平

5级。

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