Orthobiologics and Knee Osteoarthritis : A Recent Literature Review, Treatment Algorithm, and Pathophysiology Discussion - 26/10/16

Doi : 10.1016/j.pmr.2016.07.004

David M. Crane, MD ^a,^b,^c,^⁎ , Kristin S. Oliver, MD, MPH ^a,^b,^c,^d, Matthew C. Bayes, MD ^a,^c
^a Bluetail Medical Group, St Louis, MO, USA
^b Bluetail Medical Group, Naples, FL, USA
^c 17300 North Outer 40 Drive, Suite 201, Chesterfield, MO 63005, USA
^d Bluetail Medical Group, Columbia, MO, USA

^∗Corresponding author. 17300 North Outer 40 Drive, Suite 201, Chesterfield, MO 63005.17300 North Outer 40 DriveSuite 201ChesterfieldMO63005

Résumé

This article reviews the current options in orthobiologics for the clinical treatment of knee osteoarthritis (OA). We describe a new model of knee OA that fills the gap in our understanding of it as a purely traumatic and/or inflammation-induced cartilage degenerative condition, to a current model of multinodal pathophysiology. We discuss graft choice and patient selection in the current state of understanding of the treatment of knee OA in a tissue engineering model with orthobiologics. We present a sample treatment algorithm and decision nest for deciding how to proceed with patient care.

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Keywords : Knee osteoarthritis, Fat lipoaspirate, Orthobiologics, Tissue engineering, Meniscus, Extrusion, Stem cell depletion model, Multinodal pathophysiology