Joint Preservation Techniques for the Knee in 2023: The Utility of Biologics, Osteotomies and Cartilage Restoration Procedures (2023 Annual Meeting)-Biologics and Joint Preservation

Video Transcription

Video Summary

Dr. Sherman from Stanford discusses the current state and potential of biologics in knee joint preservation surgery. Biologics—such as PRP, bone marrow aspirate concentrate (BMAC), adipose tissue, and placental-derived products—are bioactive molecules used to enhance healing by modulating anabolic and anti-catabolic processes. However, many products, like amnion, are under FDA study and not widely used clinically. Importantly, mesenchymal stem cells (MSCs) act as "medicinal signaling cells" that modulate the environment rather than directly regenerating cartilage. Evidence for biologics remains evolving and imperfect, requiring cautious application. In meniscus repair, biologic augmentation shows mixed results, with PRP reducing re-tear rates but not conclusively superior to simpler techniques. Osteochondral allografts benefit from biologics like BMAC, but data is inconclusive. Biologics show promising results in treating bone marrow lesions and early osteoarthritis. Scaffold technologies and combined cell, scaffold, and signal approaches are emerging but lack long-term data. Ultimately, evidence-based use and continued research are essential for integrating biologics clinically.

Asset Caption

Seth Sherman, M.D.

Keywords

biologics

knee joint preservation

mesenchymal stem cells

PRP

osteochondral allografts