March 2017: TOBI Faculty Publications

Apr 7

March 2017: TOBI Faculty Publications

Below is a resource of all March 2017 regenerative medicine publications authored by TOBI Speakers and Faculty, including alumni faculty. Each month, we compile a list with links and brief summaries of all new research and studies to keep TOBI community members informed and on the cutting edge of regenerative medicine research. Studies are listed alphabetically by TOBI Faculty names.

If you are a TOBI Faculty member or alumni and would like your publications included in the TOBI monthly publications blog, please send it to

1 March 2017, Materials Science & Engineering, C: Materials for Biological Applications

Personalized plasma-based medicine to treat age-related diseases.
Personalized medicine is emerging as a promising and appealing therapeutic option. The use of patient’s own plasma and platelets as therapeutics is providing new avenues in the treatment of acute and chronic tissue injuries by promoting tissue repair and regeneration. This review, by TOBI 2017 Faculty Eduardo Anitua, MD, summarizes the recent advances and challenges in the field of personalized plasma-based medicine and its potential to treat age-related diseases.
See the full study here.

27 March 2017, Muscle & Nerve

Nerve conduction velocity and cross sectional area in ulnar neuropathy at the elbow
TOBI 2017 Faculty alumni Marko Bodor, MD, and his coauthors investigated findings in ulnar neuropathy at the elbow, particularly the difference in findings between electrodiagnostic (EDx) and ultrasonographic (US) in the precise localization of ulnar neuropathy at the elbow. In this study, they explored the relationship between the two methods.
See the full study here.

28 March 2017, Arthroscopy

Patient Understanding, Expectations, Outcomes, and Satisfaction Regarding Anterior Cruciate Ligament Injuries and Surgical Management
Patient satisfaction has become an increasingly important outcome metric in orthopaedics and medicine in general as many initiatives at both the state and national levels aim to improve the efficiency and quality of health care. Anterior cruciate ligament injuries are among the most common injuries in orthopaedics, with anterior cruciate ligament reconstruction (ACLR) surgery consistently reported as one of the most frequently performed procedures by orthopaedic surgeons. Patient-reported outcomes are frequently used to evaluate outcomes from the patient’s perspective, and many physicians also ask patients about their satisfaction with treatment. In this article, TOBI Faculty Brian J. Cole MD, reviews the orthopedic literature regarding the relation between preoperative patient expectations and postoperative patient satisfaction. The authors also cover quality of online resources, patient expectations for ACLR, and factors associated with and/or predictive of either poor or good to excellent outcomes after surgery are described.
See the full study here.

1 March 2017, Sports Medicine and Arthroscopy Review

Publication insights: Failure of Bone Marrow Stimulation Techniques
Marrow stimulation techniques, including microfracture, are among the most commonly performed cartilage restoration procedures for symptomatic chondral defects of the knee. For the vast majority of patients, marrow stimulation results in reduced pain and improved function, providing overall satisfactory outcomes. In some cases, however, marrow stimulation fails, resulting in symptom recurrence and often, the need for repeat surgery. This review, done in part by TOBI Faculty Brian J. Cole, MD, will describe the indications and outcomes of microfracture as a primary surgical treatment for focal chondral defects of the knee, identify patient and procedure-specific factors associated with poor clinical outcomes, and will discuss treatment options and their respective outcomes for patients with a failed prior microfracture surgery.
See the full publication here.

23 March 2017, Arthroscopy

Dial Test: Unrecognized Predictor of Anterior Cruciate Ligament Deficiency
The purpose of this study, conducted by TOBI Faculty Brian J. Cole, MD, was to evaluate the effect of isolated anterior cruciate ligament (ACL) injury on tibial external rotation as measured by the dial test. Findings showed that Incompetence of the ACL accounts for nearly 7° of tibial external rotation found by the dial test. During examination of an injured knee, if the dial test is positive, an isolated ACL injury should not be excluded. Findings of the dial test should thus be interpreted with caution in the setting of ACL injury.
See the full study here.

March 2017 (Epub Nov 2016), American Journal of Sports Medicine

Prospective Clinical and Radiographic Outcomes After Concomitant Anterior Cruciate Ligament Reconstruction and Meniscal Allograft Transplantation at a Mean 5-Year Follow-up
TOBI Speaker & Faculty Alumni Brian J. Cole, MD, co-authored this study on clinical and radiographic outcomes after concomitant anterior cruciate ligament reconstruction (ACLR) and meniscal allograft transplantation (MAT). The authors concluded that concomitant ACLR/MAT can provide significant improvements in clinical outcomes and enhancement in objective knee stability. Concomitant ACLR/MAT was also associated with an insignificant degree of radiographic joint-space narrowing changes with a 5-year survivorship of more than 80% for those with data available.
See the full study here.

15 March 2017, Orthopaedic Research Society

The new MSC: MSCs as pericytes are sentinels and gatekeepers
Human Mesenchymal Stem Cells, hMSCs, were first named over 25 years ago with the “stem cell” nomenclature derived from the fact that we and others could cause these cells to differentiate into a number of different mesodermal phenotypes in cell culture. The focus of this manuscript, by longtime TOBI Speaker Arnold I. Caplan, PhD, is to present the current information about MSC function in situ and to emphasize how these new observations provide insight into understanding the role of the pericyte/MSC in skeletal activities including our new hypothesis for how these cells act as a gatekeeper for metastasis of melanoma into bone.
See the full study here.

22 March 2017, Veterinary Surgery

Effect of needle diameter on the viability of equine bone marrow derived mesenchymal stem cells.
Mesenchymal stem cells (MSCs) are frequently delivered via needle injection for treatment of musculoskeletal injuries. The purpose of this study, by TOBI Speaker Alumni Lisa A. Fortier, DVM, PhD, was to evaluate the effect of needle diameter on the viability of MSCs. The authors concluded that Cell damage is more likely when MSCs are passed through 25-ga rather than 20-ga needles.
See the full study here.

3 March 2017, Journal of Pediatric Orthopedics

Return to sport activities after subtalar arthroereisis for correction of pediatric flexible flatfoot.
The aim of this study was to establish whether children treated with subtalar arthroereisis for flexible flatfoot were able to return to sport activities. TOBI Faculty alumni Nicolò Martinelli, MD, and coauthors reviewed 49 patients with a mean age at the time of surgery of 10.7 years. The type of sport activities, the number of sessions per week, the time dedicated to each session, and the level achieved were assessed preoperatively and at the last follow-up. Overall, 45 patients returned to sports after surgery. Surgery did not alter the duration, frequency, and type of sporting activities, but the participation in physical activities as well as the emotional status and footwear issues improved.
See the full study here.

24 March 2017, Britich Medical Bulletin

Apoptosis and rotator cuff tears: scientific evidence from basic science to clinical findings.
In this article, TOBI 2017 Speaker Nicola Maffulli, MD, PhD contributed to a review of scientific evidence surrounding apoptosis as a cause of tendinopathy, and the biologic treatments that may affect the process of apoptosis. Excessive apoptosis has been hypothesized as possible cause of tendinopathy and tear in the tendons of the rotator cuff (RC). Different mechanisms and molecules play a key role in cell regulation. Biological interventions can affect the process of apoptosis to control the tendinopathy process, and may be useful to design new treatments.
The authors identified basic science, in vitro and in vivo preclinical and clinical studies listed in the Pubmed Google Scholar, CINAHL, Cochrane Central and Embase Biomedical databases concerning the effects of apoptosis on RC tendons.
See the full study here.

4 March 2017, British Medical Bulletin

The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review
TOBI 2017 Speaker Nicola Maffulli, MD, PhD has another March publication with this review of evidence regarding effectiveness of prolotherapy in treating knee osteoarthritis (OA). OA is treated with a wide range of modalities, both conservatively and surgically. Prolotherapy has been used to treat various musculoskeletal problems and has shown some promise. Moderate evidence suggests that prolotherapy is safe and can help achieve significant symptomatic control in individuals with OA. The authors concluded that future research should focus on larger sample size, standardization of treatment protocol and basic science evidence.
See the full study here.

25 March 2017, Sports Medicine & Arthroscopy Review

Surgical Treatment for Failure of Repair of Patellar and Quadriceps Tendon Rupture With Ipsilateral Hamstring Tendon Graft.
Tears of the patellar and quadriceps tendon are common in the active population, especially in athletes. At present, several techniques for surgical repair and reconstruction are available. When reruptures occur, a reconstruction is mandatory. In the present paper, Nicola Maffulli, MD, PhD, and coauthors, describe a surgical technique for patellar and quadriceps tendon reconstruction using ipsilateral hamstring autograft. After routine hamstring tendon harvesting, the tendon ends are prepared using a whip stitch. A transverse tunnel is drilled in the midportion of the patella, the hamstring graft is passed through the patella, and firmly secured to the patellar tunnel openings with sutures. The details of the technique are fully described. Autologous ipsilateral hamstring tendon grafts provide a secure sound means to manage these challenging injuries.
See the full publication here.

20 March 2017, Pain Physician

Platelet Rich Plasma in Musculoskeletal Pathology: A Necessary Rescue or a Lost Cause?Platelet rich plasma (PRP) has been used for decades to facilitate surgical tissue repair; therefore, the current trend of percutaneously injecting PRP to theoretically enhance tissue regeneration and repair is a logical progression. Applications include treatment of osteoarthritis, tendinopathy, chondropathy, acute and chronic soft tissue injuries, muscle or ligament tear, as well as enhancement of healing after bone or tissue reconstruction. However, there is limited evidence to support the use of PRP in the abovementioned conditions. TOBI Speaker and Faculty Annu Navani, MD, co-authored this publication to provide a basic overview of the current use of PRP in treating musculoskeletal conditions.
See the full study here.

23 March 2017, Clinical Orthopaedics and Related Research

Letter to the Editor: What Does a Shoulder MRI Cost the Consumer?
More than 100 MRIs per 1000 inhabitants are performed in the United States annually, more than almost every other country. Little is known regarding the cost of obtaining an MRI and factors associated with differences in cost. TOBI Faculty Alumni Hollis Potter, MD, wrote a response to this paper regarding the cost to the consumer of a shoulder MRI at independent imaging centers compared with hospital-owned centers.
Access the response here.

1 March 2017, American Journal of Sports Medicine

Passive Anterior Tibial Subluxation in the Setting of Anterior Cruciate Ligament Injuries
A Comparative Analysis of Ligament-Deficient States
In his second March publication in the TOBI publications post, Faculty Alumni Hollis Potter, MD, examines determine static relationships between the tibia and femur in patients with various states of ACL deficiency and to identify factors associated with anterior tibial subluxation. Results concluded that knees with failed ACLR are associated with more anterior tibial subluxation than those with primary ACL deficiency. In primary ACL-deficient knees, anterior tibial subluxation is associated with chondral injuries and meniscal tears but not injury chronicity.
See the full study here.

1 March 2017 (first pub 26 Oct 2017), Stem Cells Translational Medicine

Safety Studies for Use of Adipose Tissue-Derived Mesenchymal Stromal/Stem Cells in Rabbit Model
Adipose-derived mesenchymal stem cells (AMSCs) offer potential as a therapeutic option for clinical applications in musculoskeletal regenerative medicine because of their immunomodulatory functions and capacity for trilineage differentiation. In preparation for a phase I clinical trial using AMSCs to treat patients with osteoarthritis, TOBI Faculty & Speaker Jay Smith, MD, and coauthors, of the Mayo Clinic, carried out preclinical studies to assess the safety of human AMSCs within the intra-articular joint space in a rabbit model. Treatment outcomes and safety were evaluated by assessing the general health, function, and behavior of the animals. Joint tissues were analyzed by x-ray, magnetic resonance imaging, and histopathology.
See the full study here.

BREAKING PRP NEWS: Arthoscopy Journal Endorses PRP

Although this was not written by TOBI Faculty, the endorsement of PRP by Arthroscopy Journal in their March edition was a breaking development for regenerative medicine. Editor Timothy J. Hunt, MD, wrote, “the time has come for those of us who have not yet tried platelet-rich plasma injections in our patients with symptomatic knee osteoarthritis to do so.”
See the full editorial here.

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