Orthobiologics - PRP, BMC the real story so far!
-
Upload
vaibhav-bagaria -
Category
Healthcare
-
view
583 -
download
0
description
Transcript of Orthobiologics - PRP, BMC the real story so far!
ORTHOBIOLOGICS: FROM UNKNOWN UNKNOWNS TO KNOWN KNOWNS: THE STORY SO FAR ...
Dr Vaibhav Bagariambbs ms fcps
Consultant Joint Replacement & Sports SurgeonCARE Hospital, Nagpur
Chief innovation officer- ORIGYN Healthcare
1Wednesday, 4 June 14
ONCE UPON A TIME...
3000 BC : As per Mahabharata, Adi Parva, chapter 114, shloka 17, the Kaurava were created by splitting the single embryo into 101 parts and growing each part in a separate kund or container. It is believed that Kaurva’s birth mentioned here is first reported mention of what could
be possible use of embryonic stem cell.
2Wednesday, 4 June 14
UNKNOWN UNKNOWNS
Why some people healed better than others?
Why certain organs regenerated and repaired on their own?
Can human body’s inherent regeneration potential be harnessed?
What would be potential fall outs - cost, ethical and moral issues?
3Wednesday, 4 June 14
NOT LONG AGO...
We looked for mechanical solutions to the biological problem.
Over the years we realised that ‘it is Biology Stupid’!
Now we are increasingly looking for Biological solutions to biological problem!
4Wednesday, 4 June 14
STEM CELL RESEARCH TIMELINE
5Wednesday, 4 June 14
CURRENT KNOWN KNOWNS
Stem cell, growth factor and scaffolds interplay
Mechanism of Repair & Regeneration.
Potential therapeutic Role
Future directions in orthobiologics..
6Wednesday, 4 June 14
WHAT ARE STEM CELLS?
… ‘uncommitted’ cells with the capacity for unlimited or prolonged self renewal and the ability to give rise to differentiated cells under appropriate conditions.
7Wednesday, 4 June 14
STEM CELL CHARACTERISTICS
Undifferentiated cells with the capacity for unlimited or prolonged self-renewal that can give rise to differentiated cells.
Self renewing for long periods.
Unipotent / pluripotent / multipotent e.g. Intestinal stem cells produce one or more of the 4 classes of mature differentiated cells (absorptive, goblet, Paneth and enteroendocrine cells)
8Wednesday, 4 June 14
STEM CELL CHARACTERISTICS
Plasticity : The formation of one differentiated cell type from another.
Slow cycling in cell division.
Specific gene expression
9Wednesday, 4 June 14
SOURCES OF STEM CELLS
Adult Tissue: Hematopoeitic SC, Mesenchymal SC, Neural, muscle derived, Pancreatic, Hepatic, Epithelial, Dental.
Fetal Tissue
Cord blood
Embryo’s ( ESC)
!
10Wednesday, 4 June 14
BROAD CLASSIFICATION
EMBRYONIC STEM CELLS
ADULT STEM CELLS
11Wednesday, 4 June 14
HEALING TRINITY
12Wednesday, 4 June 14
THIS TALK
Concentrated Bone marrow products & Applications
Platelet rich plasma product & Application
13Wednesday, 4 June 14
BONE MARROW DERIVED CELLS
Hematopoietic stem cell
1. CD34 “+” Cells
2. Abundant cells
3. Progenitors
4. Non Adherent
Mesenchymal stem cell
1. CD34 “–” Cells
2. Rare cells
3. Total undifferentiated
4. Adherent
14Wednesday, 4 June 14
BONE MARROW CONCENTRATE
Enhances levels of Bone Marrow-Mesenchymal Stem (BM-MS) Cells
BM-MS cells decrease with age
Concentrating mimics the cell load and healing potential of young patients
4-5x progenitor cell increase above baseline
15Wednesday, 4 June 14
BONE MARROW COCKTAIL
Endothelial Progenitor Cells: for supporting vasculature. Healing is impaired until the vasculature is restored. Stimulate BM-MS cells
Hematopoietic Stem Cells
Platelets: to modulate the regeneration process – MIGRATION HIGHWAYS. Recruit bone marrow progenitor cells to foci of injury, Provide adhesion sites for stem cells
Adhesion Molecules: Mediate cell-to-cell adhesion, Maintenance of tissue integration, wound healing, and cellular migration
16Wednesday, 4 June 14
POST PROCESSING RESULTS
17Wednesday, 4 June 14
BMAC USES
18Wednesday, 4 June 14
BMAC IN NON UNIONS
19Wednesday, 4 June 14
BMAC IN AVN
20Wednesday, 4 June 14
BMAC FOR CARTILAGE REPAIR
21Wednesday, 4 June 14
BMAC IN SPINAL FUSION
22Wednesday, 4 June 14
PLATELETS
Specialised type of blood cells
Major role in injury healing
Reservoirs of natural growth factor
23Wednesday, 4 June 14
GROWTH FACTORS
24Wednesday, 4 June 14
PLATELET CONCENTRATES
Affect mitogenic activity of resident osteoblasts & undifferentiated cells
Act on undifferentiated cells with respect to cell recruitment (chemo-attraction)
Increases the attraction of undifferentiated cells to the wound site but also proliferation of those cells.
Can even allow for a reduction in autograft requirements by accelerating healing
25Wednesday, 4 June 14
PRP VS NORMAL PLASMA
26Wednesday, 4 June 14
PRP & HEALING
27Wednesday, 4 June 14
PRP USES
SPORT INJURIES:Tennis Elbow, ACL Tears, Rotator Cuff Tears, Plantar Fasciitis
SPINE FUSIONS
CARPAL TUNNEL SYNDROME
ARTHRITIC JOINTS
DEGENERATIVE DISC DISEASE
28Wednesday, 4 June 14
TRAILER - ROAD AHEAD
Promising
Bumpy
hope vs hype
Use judgement & common sense
Event Horizon: Best way to predict future is to create it!
29Wednesday, 4 June 14
TRAILER - ROAD AHEAD
Promising
Bumpy
hope vs hype
Use judgement & common sense
Event Horizon: Best way to predict future is to create it!
29Wednesday, 4 June 14
THANK YOU...
www.drbagaria.com
30Wednesday, 4 June 14
THANK YOU...
www.drbagaria.com
30Wednesday, 4 June 14