Biologic Orthopedics Journal 2021-07-31T17:38:54+00:00 Scott Bryant Open Journal Systems <p style="margin: 0px; line-height: 115%;"><span style="margin: 0px; line-height: 115%; font-family: 'Garamond',serif; font-size: 14pt;">The Biologic Orthopedics Journal is being launched as a new online resource of evidence-based research and analysis, along with thoughtful discussion and commentary related to approaches to orthopedic biologics, their use and their promotion. The Journal will provide free and open access to scholarly work, education and discussion to meet the needs of practitioners, health workers, researchers, scientists and policy makers. The journal will be managed by the Biologic Orthopedics Journal Association, which will be responsible for administering the process of article submissions, review, and publication along with the supporting complements, a website and digital platform to empower readers of the journal and connect them to critical resources.</span></p> <p style="margin: 0px; line-height: 115%;"><span style="margin: 0px; line-height: 115%; font-family: 'Garamond',serif; font-size: 14pt;">&nbsp;</span></p> <p style="margin: 0px; line-height: 115%;"><span style="margin: 0px; line-height: 115%; font-family: 'Garamond',serif; font-size: 14pt;">The Journal articulates and disseminates new science and clinical research for advancing the scholarship and practice of regenerative medicine in the field of orthopedics and to provide evidence-based best practices.<span style="margin: 0px;">&nbsp; </span>The journal also increases world-wide exposure to the innovations, experiences and perspectives of practitioners working in the field. Article submissions are encouraged from throughout the world, and be subject to peer review. As such, this journal serves as a reputable and authoritative resource to help influence clinical practice, research funding, policy, and operational decisions regarding biologics in orthopedics.&nbsp;</span></p> Orthobiologics: Filling the Gaps in Current Orthopaedic Surgical Treatment 2021-03-31T19:10:35+00:00 William D Murrell <p>N/A</p> 2021-04-06T00:00:00+00:00 Copyright (c) 2021 Biologic Orthopedics Journal Safety and Efficacy of Mesenchymal Stromal Cells and Platelet-Rich Plasma for the Treatment of Moderately Advanced Post-Traumatic Arthritis of the Ankle 2021-02-03T05:44:06+00:00 Henry Stiene <p><strong>Background:</strong> Orthobiologics such as mesenchymal stromal cells and platelet-rich plasma are intensely being investigated as treatment options for osteoarthritis. The purpose of this retrospective case series is to evaluate the safety, adverse events, long-term outcomes, and efficacy of bone marrow concentrate (BMC) combined with platelet-rich plasma (PRP) to treat moderate to advanced Kellgren-Lawrence (KL3-4) post-traumatic ankle osteoarthritis.<br /><strong>Methods:</strong> Study population at final follow-up included 19 patients with 22 treated ankles with post-traumatic ankle osteoarthritis with a mean duration of symptoms of 56 months before treatment with ultrasound-guided intra-articular injection of BMC and PRP. Patients were followed prospectively from the time of treatment for a mean of 2.6 years at final follow-up. Pre and post Foot and Ankle Disability (FADI) scores were tabulated to assess outcomes, and 7 patients also completed the FADI sports module. Total nucleated cell counts were obtained on all treated patients and Mishra Type 3A PRP was utilized.<br /><strong>Results:</strong> A total of 19 of 22 ankles treated showed improvement in their FADI scores. Thirteen of the 19 who had improved FADI scores patients reached MCID (P = .17). Three of the six patients who did not reach MCID eventually underwent ankle arthrodesis. The average patient age was 56 years old. There was no correlation between the history of previous surgery, KL grade, sex, or age in terms of outcomes. Seven patients completed the sports module of the FADI, and none reached MCID. Patients with a shorter duration of symptoms had higher post-FADI scores reaching MCID (P &lt; .001). The three patients who underwent arthrodesis had the longest duration of symptoms of 84, 84, and 120 months. No adverse effects were reported in the study group. Total nucleated cell count (TNCC) did not correlate with outcomes in this group, and there was no correlation of TNCC based on age and sex.<br /><strong>Conclusion:</strong> BMC combined with PRP is a safe treatment option for patients with moderate to advanced ankle arthritis and can provide functional pain relief for a sustained period and delay or possibly obviate the need for future ankle arthrodesis. A shorter duration of symptoms may lead to improved outcomes.</p> <p>Â </p> 2021-05-26T00:00:00+00:00 Copyright (c) 2021 Biologic Orthopedics Journal A 12-Month Cohort Study to Investigate Changes in Patient-Reported Outcomes after Intra-articular Injection of Micro-Fragmented Adipose Tissue for Knee Osteoarthritis 2020-12-04T11:46:53+00:00 Nathan Hogaboom Ella D'Amico Ken Mautner Christopher Rogers Gerard Malanga <p><strong>Background</strong><br />To evaluate changes in pain, function, and quality of life after treatment with injected micro-fragmented adipose tissue (MFAT) for knee osteoarthritis in a large cohort of individuals treated at multiple centers.</p> <p><strong>Methods</strong><br />One hundred ten individuals were recruited from three private outpatient clinics. Participants had to be diagnosed with symptomatic knee OA (defined by persistent knee pain associated with clinical symptoms of OA and/ or classic imaging findings) and who had not received prior knee surgery or treatment with platelet-rich plasma, cortisone, or hyaluronic acid within the previous 6 weeks. Data from 120 knees were included in the analysis. Outcome measures included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, activities of daily living [ADL], sports and recreation, quality of life [QOL]) and an 11-point Numerical Rating Scale (NRS) for average knee pain over the past week. Outcomes were collected at baseline and 3, 6, and 12 months.</p> <p><strong>Results</strong><br />Significant increases and decreases in KOOS subscale and NRS scores were observed, respectively, in the cohort as a whole (p&lt; .05). Lower BMI was associated with more significant improvements in pain, sports/recreation, and ADL KOOS subscale scores (p&lt; .05). Greater age was associated with more significant improvements in symptoms and QOL subscale scores (p&lt; .05).</p> <p><br /><strong>Conclusions</strong><br />A single injection of MFAT improved pain, function, and QOL outcome measures up to 12 months in this cohort for more than half of the participants. Greater BMI and lower age negatively influenced outcomes. It is not known whether improvements continue after this timeframe or why many participants reported little-to-no improvement.</p> 2021-06-02T00:00:00+00:00 Copyright (c) 2021 Biologic Orthopedics Journal The Effect of Combined Bone Marrow Aspirate, Lipoaspirate, and Platelet Rich Plasma Injections on Pain, Function, and Perceived Change Amongst Individuals with Severe Knee Osteoarthritis 2021-07-31T17:38:54+00:00 Morey Kolber Joseph Purita Jose Fabio Santos Duarte Lana Paul Salamh William Hanney <p><strong>Background:</strong> Owing to a paucity of research on minimally processed orthobiologics, we sought to investi-gate the efficacy of minimally processed bone marrow aspirate (BMA) and fat graft with a leukocyte-rich, platelet-rich plasma (PRP) intra-articular injection series on pain, function, and global rating of change (GROC) among patients with severe knee osteoarthritis (OA).<br /><strong>Methods:</strong> Thirty-one adults (23 females and 8 males, mean age 67 years) with clinical and radiographic evidence of knee OA (Kellgren–Lawrence ≥ 3) were included. During the initial visit, patients were exam-ined and administered the patient-specific functional scale (PSFS) and a numerical pain rating scale ranging from 0 to 10. Patients then underwent procedures to obtain 4–6 mL of PRP, a minimally processed 6 mL fat graft, and 10 mL of BMA. Patients returned twice over 6-week intervals for booster PRP injections. At each follow-up (F1 and F2), the GROC questionnaire and prior outcome measures were completed.</p> <p><strong>Results:</strong> Patients returned at an average of 41 days for the second PRP (F1) and 90 days from initial visit for the third PRP injection (F2). Friedman Chi Square analysis indicated statistically significant improvements in pain (best and worst) and PSFS from initial to F1 and F2 (P ≤ 0.001). Post hoc Wilcoxon signed-ranks analysis with Bonferroni correction identified improvement from initial to F1 and F2, as well as F1–F2 for pain, PSFS, and GROC (P ≤ 0.013). Effect sizes ranged from r = 0.32 to 0.51. Change, based on established minimum clinically important differences, indicated pain, GROC, and PSFS met thresholds at F2.</p> <p><strong>Conclusion:</strong> A minimally processed fat graft with BMA and a series of three PRP injections improved pain and function among individuals with severe knee OA who were previously recalcitrant to conservative care. Although results indicated significant improvement, clinically important change did not occur until F2. A one-arm design is a limitation of this study.</p> 2021-10-05T00:00:00+00:00 Copyright (c) 2021 Biologic Orthopedics Journal Viewpoint Combat COVID-19 with Exercise and Vitamin D Supplementation 2021-01-23T16:56:16+00:00 Allan Mishra William D Murrell <p>COVID-19 is a raging pandemic with cases, hospitalizations and deaths surging. Prevention has focused to date on mask wearing, social distancing, and the development of vaccines. Novel mitigation strategies, however, are needed to combat the pandemic optimally.<br />There was an epidemic of inactivity in 2020 partially because of government recommendations to stay indoors and the mandated closure of gyms. Vitamin D deficiency is also a common worldwide problem, especially for persons of color. These two issues are contributing to the severity of the pandemic and should be addressed.</p> 2021-01-30T00:00:00+00:00 Copyright (c) 2021 Biologic Orthopedics Journal