AANA25 Knee Access Pass-CONCURRENT SESSION 1A: AANA/BA Session: Knee and Shoulder

Video Transcription

Video Summary

The session, led by Scott Rodeo of the Biologics Association (BA), provided a comprehensive overview of current trends and research in biologic therapies, particularly Platelet-Rich Plasma (PRP), orthobiologics, bone marrow aspirate concentrate (CBMA), and exosomes in orthopedic applications. The BA’s mission emphasizes ethical, evidence-based use and standardization in biologic therapy, with efforts including the BARB registry and potential collaboration with the AAOS to link clinical and biospecimen data.<br /><br />Don Buford highlighted PRP analysis, emphasizing key parameters such as platelet dose, concentration, recovery percentage, and cost efficiency. He noted that platelet dose correlates best with outcomes over leukocyte content and described the importance of evaluating PRP kits based on effective platelet yield rather than price alone.<br /><br />Research into PPP (platelet-poor plasma) for muscle injuries suggests it may promote myoblast differentiation and faster recovery than PRP, as platelet-rich formulations contain factors like TGF-beta and myostatin, which may inhibit muscle regeneration. Early clinical data supports PPP’s potential in muscle healing, though more research is needed.<br /><br />Catherine Esser examined bilateral cytokine profiles post-ACL injury, revealing systemic inflammatory responses affecting contralateral joints, questioning the use of the uninjured knee as a control. Elevated biomarkers correlated with functional impairment and chronic joint remodeling, indicating that both knees may require attention in ACL rehabilitation.<br /><br />Eric Furkel discussed CBMA in talar osteochondral lesions, describing techniques combining autograft, extracellular matrix scaffolds, and bone marrow aspirate to enhance cartilage and bone repair, resulting in improved clinical and imaging outcomes.<br /><br />Brian Cole reviewed orthobiologics in surgical adjuncts like ACL reconstruction, meniscal repair, cartilage regeneration, and rotator cuff healing. Evidence suggests PRP can reduce pain and retear rates in rotator cuff repair, bone marrow concentrate may improve early ligamentization, and marrow venting assists meniscal repair. However, heterogeneity in protocols limits definitive conclusions.<br /><br />Prithav Jaram emphasized patient communication about biologics, noting the heterogeneity and complexity of products like PRP, MFAT, and BMAC, highlighting the importance of understanding mechanisms to set realistic expectations.<br /><br />Scott Bruder provided an update on exosomes, extracellular vesicles involved in cell signaling, with significant potential for therapeutic use in orthopedics. He clarified regulatory status, noting no FDA-approved exosome products for treatment yet, warning against unregulated commercial use.<br /><br />Panel discussions focused on optimal PRP dosing, injection techniques, post-injection protocols, regulatory changes (notably Florida’s stem cell legislation), and indications best supported by evidence, including PRP for lateral epicondylitis and subchondral edema treated with BMAC. Challenges in clinical application remain due to variability in biologic formulations, dosing, and delivery techniques.<br /><br />Overall, the session underscored the promise of biologics in musculoskeletal medicine while highlighting the need for standardized methodologies, robust clinical trials, and regulatory clarity to optimize patient outcomes.

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Keywords

Biologics Association

Platelet-Rich Plasma

PRP analysis

Orthobiologics

Bone marrow aspirate concentrate

CBMA

Exosomes

ACL injury cytokine profiles

Platelet-poor plasma

Muscle injury recovery

Talar osteochondral lesions

Cartilage repair

Rotator cuff healing

Patient communication biologics

Regulatory issues stem cell therapy