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Use of biologic and regenerative therapies in managing intra-synovial soft tissue injuries
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Arthroscopic and tenoscopic surgery revolutionised our ability to treat injury to synovial structures. However, limitations including articular cartilage loss, osteoarthritis (OA) and inadequate repair of soft tissue injuries impose limitations on our success. Regenerative medicine is the process of harnessing natural healing processes to improve upon tissue repair for a more functional tissue. Biologic therapies that have been used within synovial structures include autologous conditioned serum (IRAP™, IRAP II™ in the USA and Orthokine™ in Europe), platelet rich plasma (PRP) and mesenchymal stem cells. The use of all these biologic therapies have been recently summarised in a textbook [1]. Autologous conditioned serum (ACS) has enjoyed considerable use in the clinical treatment of traumatic arthritis and osteoarthritis. Although the normal concept has been that preferential production of interleukin-1 receptor antagonist (IL-1ra) is the main mechanism of action, results are superior compared with injection of purified IL-1ra protein alone ...
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