Charles E. Schmidt College of Medicine Florida Atlantic University, Boca Raton, FL, USA.
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, 65211, USA.
Injury. 2024 Nov;55(11):111901. doi: 10.1016/j.injury.2024.111901. Epub 2024 Sep 19.
Amniotic-derived products have been used for decades in various medical subspecialties and have proven to be a safe method of allograft tissue transplantation. These products have shown promising preclinical and early clinical results in the treatment of tendon/ligament injuries, cartilage defects, and osteoarthritis. The therapeutic benefits of amniotic-derived products are likely due to intrinsic properties, such as their structure as an extracellular matrix and concentration of growth factors, as well as anti-inflammatory, antifibrotic, and antimicrobial molecules. We performed a narrative review, evaluating the pre-clinical and clinical use of amniotic-derived products in musculoskeletal injuries such as osteoarthritis, Achilles tendinopathy, plantar fasciitis, lateral epicondylitis, chronic stenosing tenosynovitis, and nerve, cartilage and tendon repair or reconstruction, along with fracture healing treatment. In vitro and pre-clinical studies using amniotic-derived products for orthopedic treatments have shown promising results and provide the foundation for further human trials to be conducted. With the rise of commercially available biologics, incorporating amniotic products into orthopedic practice is becoming more accessible, while further studies investigating long-term outcomes and potential adverse events are necessary.
羊膜衍生产品在各个医学亚专科中已经使用了几十年，已被证明是同种异体组织移植的一种安全方法。这些产品在治疗肌腱/韧带损伤、软骨缺陷和骨关节炎方面的临床前和早期临床结果显示出了良好的效果。羊膜衍生产品的治疗益处可能归因于其内在特性，例如其作为细胞外基质的结构和生长因子的浓度，以及抗炎、抗纤维化和抗微生物分子。我们进行了叙述性综述，评估了羊膜衍生产品在肌肉骨骼损伤（如骨关节炎、跟腱病、足底筋膜炎、外侧上髁炎、慢性狭窄性腱鞘炎、神经、软骨和肌腱修复或重建以及骨折愈合治疗）中的临床前和临床应用。使用羊膜衍生产品进行骨科治疗的体外和临床前研究显示出了良好的效果，为进一步进行人类试验提供了基础。随着商业上可获得的生物制剂的出现，将羊膜产品纳入骨科实践变得更加容易，同时需要进一步研究长期结果和潜在的不良事件。
