First Department of OrthopaedicsNational and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Clinique Chirurgicale St. Michel, Groupe ELSAN, Toulon, France.
Int Orthop. 2023 Jul;47(7):1645-1662. doi: 10.1007/s00264-023-05803-z. Epub 2023 Apr 18.
The use of biologic materials in orthopaedics (orthobiologics) has gained significant attention over the past years. To enhance the body of the related literature, this review article is aimed at summarizing these novel biologic therapies in orthopaedics and at discussing their multiple clinical implementations and outcomes.
This review of the literature presents the methods, clinical applications, impact, cost-effectiveness, and outcomes, as well as the current indications and future perspectives of orthobiologics, namely, platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, growth factors, and tissue engineering.
Currently available studies have used variable methods of research including biologic materials as well as patient populations and outcome measurements, therefore making comparison of studies difficult. Key features for the study and use of orthobiologics include minimal invasiveness, great healing potential, and reasonable cost as a nonoperative treatment option. Their clinical applications have been described for common orthopaedic pathologies such as osteoarthritis, articular cartilage defects, bone defects and fracture nonunions, ligament injuries, and tendinopathies.
Orthobiologics-based therapies have shown noticeable clinical results at the short- and mid-term. It is crucial that these therapies remain effective and stable in the long term. The optimal design for a successful scaffold remains to be further determined.
近年来,骨科领域(骨生物材料)对生物材料的应用受到了广泛关注。为了丰富相关文献资料,本文旨在总结骨科领域的新型生物治疗方法,并讨论其多种临床应用和结果。
本文对文献进行了回顾,介绍了骨生物材料的方法、临床应用、影响、成本效益和结果,以及目前的适应证和未来展望,包括富血小板血浆、间充质干细胞、骨髓抽吸浓缩物、生长因子和组织工程。
目前的研究采用了不同的研究方法,包括生物材料以及患者人群和结果测量,因此难以进行研究比较。骨生物材料的研究和应用的关键特征包括微创性、巨大的愈合潜力和合理的成本作为非手术治疗选择。它们的临床应用已被描述为常见的骨科疾病,如骨关节炎、关节软骨缺损、骨缺损和骨折不愈合、韧带损伤和肌腱病。
基于骨生物材料的治疗在短期和中期表现出明显的临床效果。重要的是,这些治疗在长期内保持有效和稳定。成功支架的最佳设计仍有待进一步确定。