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The influence of biologics in regenerative medicine and tissue healing
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George, Benoy (Ben) Abraham. The influence of biologics in regenerative medicine and tissue healing. Retrieved from https://doi.org/doi:10.7282/T3DF6V0X

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TitleThe influence of biologics in regenerative medicine and tissue healing
NameGeorge, Benoy (Ben) Abraham (author); Srinivasan, Shankar (chair); Rutgers University; School of Health Professions
Date Created2017
Other Date2017-05 (degree)
SubjectBiomedical Informatics, Biologicals, Anterior cruciate ligament--Surgery
Extent1 online resource (viii, 115 p. : ill.)
DescriptionBACKGROUND: Autologous bone marrow concentrate (BMAC) plus amniotic tissue products contain concentrated growth factors, CD34+ stem cells, and mesenchymal stem cells (MSCs) which yield angiogenic, trophic, and anti-inflammatory effects on tissues and may be useful in the regeneration of connective tissue. AIM: The author presents a study of 21 patients (20 ACL reconstruction, 1 ultrasound-guided injection) who received bio-enhanced STEMNEXA (BMAC plus amniotic AlphaGEMS) in conjunction with traditional treatment. METHOD: Patient data on ACL reconstruction and AT tendonitis were collected from Riordan-McKenna Institute. Post-treatment MRI images and impressions were obtained from Dr. Paul Marsh (Monticello Diagnostic Imaging). Non-surgical method (AT BMAC injection at the clinic) - In an office setting, bone marrow was aspirated from the metaphyseal area of the medial tibia and concentrated with a closed system. The resulting BMAC was injected intralesionally into the affected tendinotic mid-substance area under ultrasound guidance. Surgical method (ACL reconstruction) – In an operation room setting, bone marrow was aspirated from the iliac crest and was then placed in the Magellan centrifuge to spin down the cells to help harvest the stem cell and plasma platelet rich areas of the blood. The resulting BMAC was then injected at the time of surgery into the base of the graft to aid in healing. Searches via PubMed and Google Scholar were performed to identify both scientific investigations and review articles to ensure inclusion of pertinent data. RESULTS: The study included a sample size of 20 ACL reconstruction surgical patients between the ages of 19-57. Post-surgery MRI results with Relative Strength Intensity (RSI) measurements of ACL reconstruction graft treated with BMAC were compared against RSI of intact PCL. Between 16 and 24 weeks, the researcher noticed not only a decrease in the RSI, but also a level of saturation (plateau) indicating incorporation of the graft. The RSI for ACL and PCL closely converged between 16 and 24 weeks, clearly indicating homogeneity between the healing ACL graft and intact PCL. Research Question (RQ1): Is there a relationship between the use of biologics and decreased time to recovery/healing of injured connective tissue as compared to traditional treatment methods? Research Question (RQ2): Is there a relationship between the use of biologics and increased homogeneity of injured connective tissue as compared to traditional treatment methods? In the present study, recovery time decreased for patients who were treated with biologics (p <.05). The resulting RSI was compatible with the RSI of the uninjured, intact tendon/ligament (p<.05), thereby proving that homogeneity increased with the use of biologics. No correlation was observed between independent factors such as age and gender vs recovery time (p=1). CONCLUSION: Use of biologics (BMAC) in both the injection for AT tendinopathy and surgical ACL graft reconstruction has shown to decrease time to recovery, decrease echogenicity, and increase homogeneity of injured connective tissues toward complete healing when compared to traditional nonsurgical and surgical interventions.
NotePh.D.
NoteIncludes bibliographical references
Noteby Benoy (Ben) Abraham George
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/T3DF6V0X
Languageeng
CollectionSchool of Health Professions ETD Collection
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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