January 2017: TOBI Faculty Publications in Regenerative Medicine

Feb 9

January 2017: TOBI Faculty Publications in Regenerative Medicine

TOBI Faculty Publications: January 2017

January 2017, Stem Cells and Development
Autologous and Allogeneic Equine Mesenchymal Stem Cells Exhibit Equivalent Immunomodulatory Properties In Vitro.
TOBI Faculty C. Wayne McIlwraith, MD, published this study evaluating different methods of modulating inflammatory processes related to acute or chronic musculoskeletal injuries in the horse. They conducted studies to assess the immunological properties of equine allogeneic BMDMSCs compared with those of autologous BMDMSCs. For assessment of inherent immunogenicity, the relative ability of allogeneic and autologous BMDMSCs to stimulate spontaneous proliferation of equine lymphocytes was compared.
Access the full study here.

January 2017, The Ocular Surface
Autologous method for ex vivo expansion of human limbal epithelial progenitor cells based on plasma rich in growth factors technology.
From the Biotechnology Institute in Spain, TOBI Faculty alumni Eduardo Anitua, MD, Phd, carried out this study to Develop an autologous culture method for ex vivo expansion of human limbal epithelial progenitor cells (LEPCs) using Plasma Rich in Growth Factors (PRGF) as a growth supplement and as a scaffold for the culture of LEPCs.
See the full study here.

January 2017, Tissue Engineering: Part A
Braided and Stacked Electrospun Nanofibrous Scaffolds for Tendon and Ligament Tissue Engineering.
Tendon and ligament injuries are a persistent orthopaedic challenge given their poor innate healing capacity. Non-woven electrospun nanofibrous scaffolds composed of polyesters have been used to mimic the mechanics and topographical cues of native tendons and ligaments. However, non-woven nanofibers have several limitations that prevent broader clinical application, including poor cell infiltration as well as tensile and suture-retention strengths that are inferior to native tissues. In this study, multilayered scaffolds of aligned electrospun nanofibers of two designs – stacked or braided – were fabricated. Mechanical properties, including structural and mechanical properties and suture-retention strength, were determined using acellular scaffolds.TOBI 2017 Faculty and Speaker Rocky Tuan, PhD, published this in Tissue Engineering.
Access the full study here.

January 2017, Orthopaedic Journal of Sports Medicine
Biologic Approaches for the Treatment of Partial Tears of the Anterior Cruciate Ligament.
This valuable review by TOBI 2017 Faculty Ignacio Dallo, MD, looks at biologic treatment options for partial tears of the ACL. Anterior cruciate ligament reconstruction (ACLR) has been established as the gold standard for treatment of complete ruptures of the anterior cruciate ligament (ACL) in active, symptomatic individuals. In contrast, treatment of partial tears of the ACL remains controversial. Biologically augmented ACL-repair techniques are expanding in an attempt to regenerate and improve healing and outcomes of both the native ACL and the reconstructed graft tissue.
See the full study here.

January/February 2017, Regional Anesthesia and Pain Medicine
Clinical Efficacy of an Ultrasound-Guided Greater Occipital Nerve Block at the Level of C2.
The purpose of this prospective open-label study, authored in part by TOBI alumni faculty Matthew J. Pingree, MD, was to investigate the analgesic effects of an ultrasound-guided greater occipital nerve (GON) block at the level of C2, as the nerve courses superficially to the obliquus capitis inferior muscle.
Access the full study here.

January 2017, Clinical Journal of Sports Medicine
Concussion in Ice Hockey: Current Gaps and Future Directions in an Objective Diagnosis.
This review, from TOBI faculty alumni Jonathan T. Finoff, DO, provides an update on sport-related concussion (SRC) in ice hockey and makes a case for changes in clinical concussion evaluation. Standard practice should require that concussions be objectively diagnosed and provide quantitative measures of the concussion injury that will serve as a platform for future evidence-based treatment.
Access the review here.

January 2017, Pain Medicine
Response to: Rho et al. “Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert- Based Recommendations for Evaluation and Treatment. Part VIII: Lateral Hip and Thigh Pain”.
Read longtime TOBI speaker and faculty Dr. Gerard Malanga’s review of an article which presented an evidence-based algorithm to assist primary care providers with the diagnosis and management of lateral hip and thigh pain in older adults.
See the review here.

January 2017, Foot & Ankle International
Effect of Suture Caliber and Number of Core Strands on Repair of Acute Achilles Ruptures.
Controversy exists regarding the ideal Achilles rupture treatment; however, operative treatment is considered for athletes and active patients. The ideal repair construct is evolving, and the effect of suture caliber or number of core strands has not been studied.
In this study, completed with TOBI Faculty Thomas O. Clanton, MD, simulated mid-substance Achilles ruptures were performed in 24 cadavers. Specimens were randomized to three 6-core-strand style repair constructs: (1) 4 No. 2 sutures and two 2-mm tapes (2T); (2) 2 No. 2 sutures and four 2-mm tapes (4T); (3) 12 (double-6-strand) strand repair (12 No. 2-0 sutures [12S]). Repairs were subjected to a cyclic loading protocol representative of postoperative rehabilitation. These data were compared to a previously published standard open repair technique (6-core strands with No. 2 sutures) on 9 specimens tested under the same conditions.
Access the study here.

January 2017, Journal of Experimental Orthopedics
Effects of combined rAAV-mediated TGF-β and sox9 gene transfer and overexpression on the metabolic and chondrogenic activities in human bone marrow aspirates.
Henning Madry, MD, TOBI 2016 Speaker, contributed to this study, the findings of which report the possibility of directly modifying bone marrow aspirates by combined therapeutic gene transfer as a potent and convenient future approach to improve the repair of articular cartilage lesions.
Access the study here.

January 2017, Journal of Translational Medicine
Effects of the intradiscal implantation of stromal vascular fraction plus platelet rich plasma in patients with degenerative disc disease
Stromal vascular fraction (SVF) can easily be obtained from a mini-lipoaspirate procedure of fat tissue and platelet rich plasma (PRP) can be obtained from peripheral blood. The SVF contains a mixture of cells including ADSCs and growth factors and has been depleted of the adipocyte (fat cell) population. In this study, TOBI faculty alumni Kristin Comella, PhD, evaluated the safety and efficacy of administering SVF and PRP intra-discally into patients with degenerative disc disease.
Access the study here.

January 2017, Clinical Pharmacology & Therapeutics
Emerging Translation of Regenerative Therapies.
This translational report, published by TOBI 2017 Speaker Julie Allickson, PhD, covers current field of emerging cell therapy and tissue engineering therapies, and includes the challenges and opportunities to accelerate clinical translation in regenerative medicine. Translation of regenerative medicine refers to the transfer from bench (proof-of-concept) to bedside (clinical trials), and finally commercialization. Regenerative medicine therapies have the capacity to replace, repair, and regenerate cells, tissues, and organs to restore normal function in the body. These emerging therapies are shifting the paradigm from treatment-based to cure-based therapies.
Access the report here.

January 2017, Journal of Shoulder and Elbow Surgery
Functional results of bilateral reverse total shoulder arthroplasty.
The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks. The authors, which included TOBI Faculty alumni Brian J. Cole, MD, concluded that Bilateral RTSA provides predictable pain relief and improved function. Hygiene practices are unaltered for most patients, and the other patients rapidly develop simple compensatory strategies and retain independence in activities of daily living.
See the full study here.

January 2017, Journal of Orthopedic Surgery and Research
Functional analysis of distraction arthroplasty in the treatment of ankle osteoarthritis.
Ankle joint distraction arthroplasty (AJDA) is an alternative surgical procedure for the management of moderate to severe ankle osteoarthritis. However, the benefit of this procedure and failure relative factors are still in debate. The purpose of the current study, published in part by TOBI 2017 Faculty Wenchun Qu, MD, MS, PhD, was to evaluate the functional outcomes of AJDA in treatment of moderate to severe ankle OA and to evaluate the relative factors correlated with treatment failure.
See the full study here.

January 2017, Stem Cells Translational Medicine
Genetic Modification of Human Peripheral Blood Aspirates Using Recombinant Adeno-Associated Viral Vectors for Articular Cartilage Repair with a Focus on Chondrogenic Transforming Growth Factor-β Gene Delivery.
Transplantation of genetically modified peripheral blood aspirates that carry chondrogenically competent progenitor cells may offer new, convenient tools to treat articular cartilage lesions compared with the more complex and invasive application of bone marrow concentrates or of bone marrow-derived mesenchymal stem cells. Here, TOBI Faculty Henning Madry, MD, shows that recombinant adeno-associated viral (rAAV) vectors are powerful gene vehicles capable of successfully targeting primary human peripheral blood aspirates in a stable and safe manner, allowing for an efficient and long-term transgene expression in such samples (up to 63 days with use of a lacZ reporter gene and for at least 21 days with application of the pleiotropic, chondrogenic factor transforming growth factor-β [TGF-β]). rAAV-mediated overexpression of TGF-β enhanced both the proliferative and metabolic properties of the peripheral blood aspirates, also increasing the chondrogenic differentiation processes in these samples.
Access the study here.

January 2017, Connective Tissue Research
Hydrogels for precision meniscus tissue engineering: a comprehensive review.
This review, also published in part by TOBI 2016 Speaker Henning Madry, MD, describes the most recent advances on the use of hydrogels as platforms for precision meniscus tissue engineering. The meniscus plays a pivotal role to preserve the knee joint homeostasis. Lesions to the meniscus are frequent, have a reduced ability to heal, and may induce tibiofemoral osteoarthritis. Current reconstructive therapeutic options mainly focus on the treatment of lesions in the peripheral vascularized region. In contrast, few approaches are capable of stimulating repair of damaged meniscal tissue in the central, avascular portion. Tissue engineering approaches are of high interest to repair or replace damaged meniscus tissue in this area. Hydrogel-based biomaterials are of special interest for meniscus repair as its inner part contains relatively high proportions of proteoglycans which are responsible for the viscoelastic compressive properties and hydration grade.
Access the full study here.

January 2017, Neuromodulation
The Neurostimulation Appropriateness Consensus Committee (NACC) Recommendations for Infection Prevention and Management.
TOBI Faculty alumni Didier Demesmin, MD, investigates neurostimulation therapy for pain management. The use of neurostimulation for pain has been an established therapy for many decades and is a major tool in the arsenal to treat neuropathic pain syndromes. Level I evidence has recently been presented to substantiate the therapy, but this is balanced against the risk of complications of an interventional technique. The Neurostimulation Appropriateness Consensus Committee (NACC) concluded that adhering to established standards can improve patient care and reduce the morbidity and mortality of infectious complications in patients receiving neurostimulation.
Access the full study here.

January 2017, Arthoscopy
Optimization of Anteromedial Portal Femoral Tunnel Drilling With Flexible and Straight Reamers in Anterior Cruciate Ligament Reconstruction: A Cadaveric 3-Dimensional Computed Tomography Analysis.
TOBI Faculty Brian J. Cole, MD, and coauthors published this study in Arthroscopy: The Journal of Arthroscopic and Related Surgery. The purpose of the study was to use 3-dimensional custom CAD technology to evaluate how knee flexion angle affects femoral tunnel length and distance to the posterior wall when using curved and straight guides for drilling through the anteromedial portal (AMP).
See the full study here.

January 2017, Sports Health
The Relationship Between Pitching Mechanics and Injury.
The overhand pitch is one of the fastest known human motions and places enormous forces and torques on the upper extremity. Shoulder and elbow pain and injury are common in high-level pitchers. A large body of research has been conducted to understand the pitching motion. This is a comprehensive review, in part authored by TOBI Faculty Brian J. Cole, MD, of the literature to gain a full understanding of all currently available biomechanical and clinical evidence surrounding pitching motion analysis. These motion analysis studies use video motion analysis, electromyography, electromagnetic sensors, and markered motion analysis. This review includes studies performed between 1983 and 2016.
Access the full review here.

January 2017, Tissue Engineering Part II: Reviews
The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears.
Another study from TOBI 2017 Speaker Rocky Tuan, PhD, in which he reviews different tissue engineering strategies to improve rotator cuff healing.
Access the full review here.

December 29, 2016, Journal of Biomechanics
Sub-critical impact inhibits the lubricating mechanisms of articular cartilage.
From longtime TOBI Faculty alumni Lisa Fortier, DVM, PhD, DACVS, et al: “Although post-traumatic osteoarthritis accounts for a significant proportion of all osteoarthritis, the understanding of both biological and mechanical phenomena that lead to cartilage degeneration in the years to decades after trauma is still lacking. In this study, we evaluate how cartilage lubrication is altered after a sub-critical impact (i.e., an impact to the cartilage surface that produces surface cracking but not full thickness fissuring).”
Access the study here.

January 2017, American Journal of Physical Medicine and Rehabilitation
Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.
This case report describes what the authors, among whom is TOBI Faculty alumni Todd Stitik, MD, believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.
Access the case report here.

January 2017, Journal of Tissue Engineering and Regenerative Medicine
Traumatized muscle-derived multipotent progenitor cells recruit endothelial cells through vascular endothelial growth factor-A action.
Traumatized muscle, such as that debrided from blast injury sites, is considered a promising and convenient tissue source for multipotent progenitor cells (MPCs), a population of adult mesenchymal stem cell (MSC)-like cells. The present study, by TOBI 2017 Speaker Rocky Tuan, PhD, and his coauthors, aimed to assess the regenerative therapeutic potential of human traumatized muscle-derived MPCs, e.g., for injury repair in the blast-traumatized extremity, by comparing their pro-angiogenic potential in vitro and capillary recruitment activity in vivo to those of MSCs isolated from human bone marrow, a widely-used tissue source. MPCs were tested for their direct and indirect effects on human microvascular endothelial cells (ECs) in vitro.
Access the full study here.

January 2017, Arthroscopy
Viable Stem Cells Are in the Injury Effusion Fluid and Arthroscopic Byproducts From Knee Cruciate Ligament Surgery: An In Vivo Analysis.
This study examined the number of viable stem cells contained in the postinjury effusion fluid and the waste byproducts of arthroscopic cruciate ligament surgery. TOBI Faculty alumni Adam Anz, MD, was among the contributors. They concluded that viable stem cells are mobilized to the postinjury effusion at the time of cruciate ligament injury and can be found in the byproduct waste of cruciate ligament surgery.
Access the study here.

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