Autologous bone marrow plasma injection after arthroscopic debridement for elbow tendinosis

<p><b>INTRODUCTION</b>The treatment of tendinosis of elbow can be challenging, yet rewarding. Nevertheless, for the patients who failed conservative management and develop persistent recalcitrant symptoms, surgical intervention should be considered. The hypothesis of this study is iliac bone marrow plasma injection after arthroscopic debridement of degenerative tissue will bring along biological cure. Thus, it will not only reduce pain but also improve function in patients with resistant elbow tendonitis.</p><p><b>MATERIALS AND METHODS</b>Twenty-four patients (26 elbows) with significant persistent pain for a mean of 15 months, despite of standard rehabilitation protocol and a variety of other nonsurgical modalities were treated arthroscopically. We applied autologous iliac bone marrow plasma injection following arthroscopic debridement. This material is produced by centrifugation of iliac bone marrow blood at 1,800 rpm for 20 to 30 minutes. Patients were allowed full range of motion (ROM) exercise after 2 to 3 days. Cytokine analyses for this injective material were done. Outcome was rated by postoperative sonography, visual analog pain scores (VAS) and Mayo elbow performance scores (MEPS) at 8 weeks and 6 months follow-up. Informed consent had been obtained from the subjects, and the study protocol was approved by the ethics committee of Chosun University Hospital, Korea.</p><p><b>RESULTS</b>All patients in this study noted improvement both in their VAS and MEPS. No complication occurred in any patient. Evidence of tendon healing was observed in postoperative sonographic examination. Predominant cytokines of this study were interleukin-12 (IL-12), interferon-gamma-inducible protein-10 (IP-10) and RANTES.</p><p><b>CONCLUSION</b>Biologic treatments in orthopaedics are just beginning to evolve. In the present investigation, the injection of iliac bone marrow plasma after arthroscopic debridement in severe elbow tendinosis demonstrated early recovery of daily activities and clear improvement.</p>

Therapeutic Potential of Umbilical Cord Blood-Derived Mesenchymal Stem Cells in Ischemic Myocardium

BACKGROUND AND OBJECTIVES: We designed this study to determine the therapeutic potentials of umbilical cord blood (UCB)-mesenchymal stem cells (MSCs), as compared with bone marrow (BM)-MSCs. MATERIALS AND METHODS: MSCs were isolated from UCB and BM. For the in vivo study, myocardial infarction was induced by ligation of the left anterior descending coronary artery (LAD) in rats for 30 min, and this was followed by release; the MSCs were then injected into a designated point around the infarcted area. Echocardiographs were performed two weeks after surgery. For the in vitro study, a cDNA microarray and cytokine array were performed to compare the MSCs from UCB and from BM. Cell migration was assessed by a wound scratch assay, and the level of cardiac ankyrin repeat protein (CARP) was determined by reverse transcriptase-polymer chain reaction (RT-PCR) or Western blot analysis. RESULTS: For the echocardiograph findings, the fractional shortening (FS) was 43.9% in the UCB-MSCs group and it was 38.6% in the BM-MSC group. The ejection fraction (EF) was 79.8% in the UCB-MSC group and it was 72.4% in the BM-MSC group (control FS: 26.2% and the control EF: 56.6%). CARP was one of the highly expressed genes in the UCB-MSCs on the cDNA microarray. The mRNA and the expressed level of CARP protein in the UCB-MSCs were higher than those in the BM-MSCs. The cell migration of the CARP small interfering ribonucleic acid (siRNA) transfected UCB-MSCs was delayed compared to that of the normal UCB-MSCs (p<0.05) CONCLUSION: Our study directly compared the two types of MSCs from UCB and BM, and we suggest that the CARP molecule might be responsible for the motility of UCB-MSCs.