AANA24 Shoulder All-Access Pass-CONCURRENT SCIENTIFIC SESSION 2F: AANA/Biologic Association

Video Transcription

Video Summary

The Biologic Association session, led by Shane Shapiro and colleagues, focused on advances in orthobiologics for musculoskeletal conditions. Adam Anz discussed biologic augmentation in ACL reconstruction, emphasizing the need for rigorous translational research and showing that while bone marrow aspirate concentrate wrapped in scaffold material is safe, current evidence does not support its efficacy in improving graft maturation. Systematic reviews found insufficient support for PRP or cellular therapies in ACL repair augmentation. Scott Rodeo highlighted the complexity of biologics, focusing on PRP and cell therapies in rotator cuff repair. Current data show PRP may reduce re-tear rates in surgical repair but is not beneficial in tendinopathy. Cell therapies show promise but require further research. Don Buford stressed the importance of platelet dose in PRP treatments, noting a threshold (~3.5 billion platelets/injection) is needed for clinical efficacy in soft tissue injuries and knee osteoarthritis. Jenny Wan described military-civilian collaboration through BARB, the Biologic Association Registry and Biorepository, aiming to standardize and analyze PRP treatments, especially for knee osteoarthritis, leveraging military healthcare’s unique setting. Ken Zaslav reviewed FDA-approved acellular coraline implants that facilitate recruitment of native mesenchymal stem cells to repair cartilage and bone, showing sustained structural and clinical improvements for focal cartilage defects and mild osteoarthritis. Ariana Giannakos discussed concentrated bone marrow aspirate (CBMA) for osteochondral lesions of the talus, noting its anti-inflammatory effects, improved repair quality, and reduced revision rates when combined with bone marrow stimulation or grafts. Andrea Spiker highlighted that, unlike other sites, hip abductor repairs lack biologic augmentation evidence, with most treatments focused on synthetic or allografts. Seth Sherman outlined meniscus repair augmentation strategies such as marrow venting and PRP; marrow venting appears beneficial, whereas PRP results are mixed and variable depending on dosing and technique, with cell therapies promising but still experimental. Rajiv Pandya introduced a novel arthroscopic-assisted approach for treating subchondral bone marrow lesions—a key pain source in osteoarthritis—using precise guides to decompress lesions and deliver biologics, improving outcomes and preserving joint integrity. Aaron Critch presented a phase I cell therapy trial for hip cartilage lesions using autologous chondral tissue combined with allogeneic mesenchymal stem cells via a single-stage arthroscopic procedure, showing promising early imaging. Overall, the session highlighted that while biologics show promise across diverse musculoskeletal applications, robust clinical evidence, standardized preparations, dosing, and targeted application remain critical for advancing their safe, effective use.

Asset Caption

Introduction by Moderator: Shane A. Shapiro, M.D.

Keywords

orthobiologics

ACL reconstruction

bone marrow aspirate concentrate

platelet-rich plasma (PRP)

cell therapies

rotator cuff repair

platelet dose threshold

Biologic Association Registry and Biorepository (BARB)

FDA-approved acellular coraline implants

concentrated bone marrow aspirate (CBMA)

meniscus repair augmentation

arthroscopic-assisted subchondral bone marrow lesion treatment

phase I cell therapy trial for hip cartilage