Introduction to Bioethics: The Boundary between Research and Clinical Practice

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Special Report | Volume 1 | Issue 1 | JRS December 2021 | Page 48-50 | Graciela Moya. DOI: 10.13107/jrs.2021.v01.i01.025

Author: Graciela Moya [1] 

[1] Department of Bioethics, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Argentina, South America.

 

Address of Correspondence
Dr. Graciela Moya, MD, PhD.
Instituto de Bioética, Pontificia Universidad Católica Argentina, Argentina, South America.
E-mail: gracielamoya@uca.edu.ar

References:

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9. World Health Organization. Research Ethics Committees: Basic Concepts for Capacity-building. Geneva: World Health Organization; 2009. Available from: https://www.who.int/ethics/ethics_basic_concepts_eng.pdf [Last accessed on 2021 Oct 13].
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11. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Belmont Report, Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Available from: https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html [Last accessed on 2021 Oct 13].
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15. Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical? JAMA 2000;283:2701-11.
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19. Samuel G, Chubb J, Derrick G. Boundaries between research ethics and ethical research use in artificial intelligence health research. J Empir Res Hum Res Ethics 2021;16:325-37.

 

How to Cite this article: Moya G | Introduction to Bioethics: The Boundary between Research and Clinical Practice | Journal of Regenerative Science | Dec 2021; 1(1): 48-50.

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Multilineage-differentiating Stress-enduring (MUSE) Cells in Orthobiologics: Are they the Future?

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 44-47 | Eduard Alentorn-Geli, Patricia Laiz, Alfred Ferré-Aniorte, Roberto Seijas, David
Barastegui, Pedro Álvarez-Díaz, Xavier Cuscó, Cristina Sánchez, Luís García, Montse García-Balletbó, Ramón Cugat. DOI: 10.13107/jrs.2021.v01.i01.023

Author: Eduard Alentorn-Geli [1,2,3], Patricia Laiz [1,2], Alfred Ferré-Aniorte [1,2], Roberto Seijas [1,2], David Barastegui [1,2,3], Pedro Álvarez-Díaz [1,2,3], Xavier Cuscó [1,2], Cristina Sánchez [1,2], Luís García [1,2], Montse García-Balletbó [1,2], Ramón Cugat [1,2,3]

[1] Instituto Cugat, Hospital Quironsalud. Plaza Alfonso Comín 5-7, Planta -1, 08027 Barcelona, Spain.

[2] Fundación García Cugat, Plaza Alfonso Comín 5-7, Planta -1, 08027 Barcelona, Spain. Barcelona, Spain.

[3] Mutualidad de Futbolistas (Real Federación Española de Fútbol), Delegación catalana. Ronda Sant Pere 19-21, Entresuelo, 08010, Barcelona, Spain.

Address of Correspondence
Dr. Ramón Cugat Bertomeu, MD, PhD,
Instituto Cugat, Plaza Alfonso Comín 5-7, 08023 Barcelona, Spain.
E-mail: ramon.cugat@sportrauma.com

Abstract

Multilineage-differentiating stress-enduring (MUSE) cells are non-tumorigenic pluripotent stem cells with endogenous reparative properties. These cells have a very powerful ability to adapt to global environment changes and are thus stress-tolerant cells. Interestingly, MUSE cells can differentiate into cells representative of all three germ layers. There has been a number of studies demonstrating its powerful regenerative power in several disorders: type-1 diabetes mellitus, myocardial infarction, stroke, glomerular-related kidney diseases, chronic liver failure, and ischemia-reperfusion lung injury. Recent data have also suggested that MUSE cells have significant repair properties for osteochondral lesions. The present article will review what are MUSE cells and how they work, the application of these cells into different disorders, and the studies up-to-date regarding MUSE cells in orthobiologic.

Keywords: Muse cells, stem cells, regenerative, regeneration.

References:

1. Dezawa M. Muse cells. In: Endogenous Reparative Pluripotent Stem Cells. Japan: Springer; 2018.
2. Mahmoud EE, Kamei N, Shimizu R, Wakao S, Dezawa M, Adachi N, et al. Therapeutic potential of multilineage-differentiating stress-enduring cells for osteochondral repair in a rat model. Stem Cells Int 2017;2017:8154569.
3. Kuroda Y, Kitada M, Wakao S, Nishikawa K, Tanimura Y, Makinoshima H, et al. Unique multipotent cells in adult human mesenchymal cell populations. Proc Natl Acad Sci U S A 2010;107:8639-43.
4. Yamada Y, Wakao S, Kushida Y, Minatoguchi S, Mikami A, Higashi K, et al. S1P-S1PR2 axis mediates homing of muse cells Into damaged heart for long-lasting tissue repair and functional recovery after acute myocardial infarction. Circ Res 2018;122:1069-83.
5. Iseki M, Kushida Y, Wakao S, Akimoto T, Mizuma M, Motoi F, et al. Muse cells, nontumorigenic pluripotent-like stem cells, have liver regeneration capacity through specific homing and cell replacement in a mouse model of liver fibrosis. Cell Transplant 2017;26:821-40.
6. Uchida N, Kushida Y, Kitada M, Wakao S, Kumagai N, Kuroda Y, et al. Beneficial effects of systemically administered human muse cells in adriamycin nephropathy. J Am Soc Nephrol 2017;28:2946-60.
7. Perone MJ, Gimeno ML, Fuertes F. Immunomodulatory properties and potential therapeutic benefits of muse cells administration in diabetes. In: Dezawa M, editor. MUSE Cells Endogenous Reparative Pluripotent Stem Cells. Tokyo, Japan: Springer; 2018. p. 115-29.
8. Minatoguchi S, Mikami A, Tanaka T, Minatoguchi S, Yamada Y. Acute myocardial infarction, cardioprotection, and muse cells. In: Dezawa M, editor. Muse Cells Endogenous Reparative Pluripotent Stem Cells. Tokyo, Japan: Springer; 2018. p. 153-66.
9. Niizuma K, Borlongan CV, Tominaga T. Application of muse cell therapy to stroke. In: Dezawa M, editor. MUSE Cells Endogenous Reparative Pluripotent Stem Cells. Tokyo, Japan: Springer; 2018. p. 167-86.
10. Uchida A, Sakata H, Fujimura M, Niizuma K, Kushida Y, Dezawa M, et al. Experimental model of small subcortical infarcts in mice with long-lasting functional disabilities. Brain Res 2015;1629:318-28.

11. Uchida H, Morita T, Niizuma K, Kushida Y, Kuroda Y, Wakao S, et al. Transplantation of unique subpopulation of fibroblasts, muse cells, ameliorates experimental stroke possible via robust neuronal differentiation. Stem Cells 2016;34:160-73.
12. Uchida H, Niizuma K, Kushida Y, Wakao S, Tominaga T, Borlongan CV, et al. Human muse cells reconstruct neuronal circuitry in subacute lacunar stroke model. Stroke 2017;48:428-35.
13. Uchida N, Kumagai N, Kondo Y. Application of muse cells therapy for kidney disease. In: Dezawa M, editor. MUSE Cells Endogenous Reparative Pluripotent Stem Cells. Tokyo, Japan: Springer; 2018. p. 199-218.
14. Nishizuka SS, Suzuki Y, Katagiri H, Takikawa Y. Liver regeneration supported by muse cells. In: Dezawa M, editor. Muse Cells Endogenous Reparative Pluripotent Stem Cells. Tokyo, Japan: Springer; 2018. p. 219-41.
15. Yabuki H, Wakao S, Kushida Y, Dezawa M, Okada Y. Human multilineage-differentiating stress-enduring cells exert pleiotropic effects to ameliorate acute lung ischemia-reperfusion injury in a rat model. Cell Transplant 2018;1:963689718761657.
16. Yabuki H, Watanabe T, Oishi H, Katahira M, Kanehira M, Okada Y. MUSE cells and ischemia-reperfusion lung injury. In: Dezawa M, editor. MUSE Cells Endogenous Reparative Pluripotent Stem Cells. Tokyo, Japan: Springer; 2018. p. 293-303.
17. Yamashita T, Kushida Y, Wakao S, Tadokoro K, Nomura E, Omote Y, et al. Therapeutic benefit of Muse cells in a mouse model of amyotrophic lateral sclerosis. Sci Rep 2020;10(1):17102.
18. Toyoda E, Sato M, Takahashi T, Maehara M, Nakamura Y, Mitani G, et al. Multilineage-differentiating stress-enduring (Muse)-like cells exist in synovial tissue. Regen Ther 2019;10:17-26.

 

How to Cite this article: Geli EA, Laiz P, Aniorte AF, Seijas R, Barastegui D, Díaz PÁ, Cuscó X, Sánchez C, García L, Balletbó MG, Ramón Cugat R | Multilineage-differentiating Stress-enduring (MUSE) Cells in Orthobiologics: Are they the Future? | Journal of Regenerative Science | Dec 2021; 1(1): 44-47.

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Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Considerations

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 39-43 | Osvaldo Valle Toledo. DOI: 10.13107/jrs.2021.v01.i01.021

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.

 

Address of Correspondence
Dr. Osvaldo Valle Toledo, MD,
Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.
E-mail: osvaldovalletoledo@yahoo.es

Abstract

Plantar fasciopathy is the most common cause of heel pain. It is a primarily degenerative and mechanical overuse pathology. The plantar fascia fulfills important biomechanical functions in the foot, being its “windlass” mechanism, the most important function in this regard, allowing the foot to act as a single and efficient motor unit during gait. Its clinical and imaging diagnosis is fully defined, being Baxter’s nerve entrapment neuropathy, its most significant differential diagnosis. The elongation exercises constitute the basic treatment, being the extracorporeal shock wave therapy of significant utility, amplified in its effects by the association with the referred therapeutic exercises.

Keywords: Plantar fasciitis, shock waves, fasciopathy.

References:

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5. Harutaichun P, Boonyong S, Pensri P. Differences in lower-extremity kinematics between the male military personnel with and without plantar fasciitis. Phys Ther Sport 2021;50:130-7.
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11. Finkenstaedt T, Siriwanarangsun P, Statum S, Biswas R, Anderson KE, Bae WC, et al. The calcaneal crescent in patients with and without plantar fasciitis: An ankle MRI study. AJR Am J Roentgenol 2018;211:1075-82.
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15. Baur D, Schwabl C, Kremser C, Taljanovic MS, Widmann G, Sconfienza LM, et al. Shear wave elastography of the plantar fascia: Comparison between patients with plantar fasciitis and healthy control subjects. J Clin Med 2021;10:2351.
16. Schillizzi G, Alviti F, D’Ercole C, Elia D, Agostini F, Mangone M, et al. Evaluation of plantar fasciopathy shear wave elastography: A comparison between patients and healthy subjects. J Ultrasound 2021;24:417-22..
17. Yucel I, Ozturan KE, Demiraran Y, Degirmenci E, Kaynak G. Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc 2010;100:105-10.
18. Puttaswamaiah R, Chandran P. Degenerative plantar fasciitis: A review of current concepts. Foot 2007;17:3-9.
19. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: A randomized controlled trial. JAMA 2002;288:1364-72.
20. Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Clin Orthop Relat Res 2013;471:3645-52..

21. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
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24. Greve JM, Grecco MV, Santos-Silva PR. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis. Clinics (Sao Paulo) 2009;64:97-103.
25. Rompe JD, Meurer A, Nafe B, Hofmann A, Gerdesmeyer L. Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis. J Orthop Res 2005;23:931-41.
26. Haddad S, Yavari P, Mozafari S, Farzinnia S, Mohammadsharifi G. Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis. Int J Burns Trauma 2021;11:1-8.
27. Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, Navarro-Santana MJ, Cleland JA, Fernández-de-Las-Peñas C, et al. Is dry needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis. Pain Med 2021;22:1630-41.
28. DiGiovanni BF, Nawoczenski DA, Lintal ME, Moore EA, Murray JC, Wilding GE, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 2003;85:1270-7.
29. Avilés SG. Efectividad de las Ondas de Choque en la Fascitis Plantar. Revisión Sistemática. España: Alcalá la Real; 2017.
30. Schuitema D, Greve C, Postema K, Dekker R, Hijmans JM. Effectiveness of mechanical treatment for plantar fasciitis: A systematic review. J Sport Rehabil 2019;29:657-74.

31. Weil LS Jr., Roukis TS, Weil LS, Borrelli AH. Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: Indications, protocol, intermediate results, and a comparison of results to fasciotomy. J Foot Ankle Surg 2002;41:166-72.
32. Maier M, Steinborn M, Schmitz C, Stäbler A, Köhler S, Pfahler M, et al. Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: Prediction of outcome by magnetic resonance imaging. J Rheumatol 2000;27:2455-62.

 

How to Cite this article: Toledo OV | Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Consideration. | Journal of Regenerative Science | Dec 2021; 1(1): 39-43.

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Fundamentals of the Treatment of Male Erectile Dysfunctions with Low Intensity Shockwaves

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 26-29 | César Eisner, Mauricio Salas, Daniel Moya. DOI: 10.13107/jrs.2021.v01.i01.015

Author: César Eisner [1], Mauricio Salas [2], Daniel Moya [3]

[1] Shockwave Argentina, Buenos Aires, Argentina.

[2] Clínica Instituto de Urología y Sexología, Santiago de Chile, Chile.

[3] Department of Orthopaedics, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires, Argentina.

Address of Correspondence
Dr. César Eisner, MD
Shockwave Argentina, Buenos Aires, Argentina.
E-mail: : info@shockwaveargentina.com

Abstract

Male erectile dysfunction (ED) is one of the most common problems among men worldwide. No single diagnostic method evaluates all the
variables of this complex condition. To achieve good therapeutic results, it is essential to base the treatment on an accurate diagnosis. Hemodynamic exploration by echo Doppler of the cavernous arteries, especially since the incorporation of intracavernous administration of vasoactive drugs, is a useful tool that allows the evaluation of erectile dysfunction in the arterial phase. It is also considered to be the choice in the assessment of the corporoveno-occlusive mechanism. Different treatment methods are used, being PDE5 (sildenafil and tadalafil), the treatment of the first choice in several conditions. The number of publications of low-intensity extracorporeal shockwave treatment (LI-ESWT) for ED has increased dramatically in recent years. Scientific evidence regarding the application of LI-ESWT for the treatment of erectile dysfunction is still controversial. Inclusion criteria of the studies and the wide variety of treatment protocols have been criticized. On the other hand, most of these studies report encouraging results with no short-term adverse effects, regardless of variation in LI-ESWT setup parameters or treatment protocols.

Keywords: Erectile dysfunction, Linear shock wave, Linear shock wave therapy, Shear wave elastography.

References:

1. Porst H. Review of the current status of low intensity extracorporeal shockwave therapy (Li-ESWT) in erectile dysfunction (ED), Peyronie’s disease (PD), and sexual rehabilitation after radical prostatectomy with special focus on technical aspects of the different marketed ESWT devices including personal experiences in 350 patients. Sex Med Rev 2021;9:93-122.
2. Clavijo RI, Kohn TP, Kohn JR, Ramasamy R. Effects of low-intensity extracorporeal shockwave therapy on erectile dysfunction: A systematic review and meta-analysis. J Sex Med 2017;14:27-35.
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11. Huang SA, Lie JD. Phosphodiesterase-5 (PDE5) inhibitors in the management of erectile dysfunction. P T 2013;38:407-19.
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13. Sokolakis I, Dimitriadis F, Psalla D, Karakiulakis G, Kalyvianakis D, Hatzichristou D. Effects of low-intensity shock wave therapy (LiST) on the erectile tissue of naturally aged rats. Int J Impot Res 2019;31:162-9.
14. Liu T, Shindel AW, Lin G, Lue TF. Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy. Int J Impot Res 2019;31:170-6.
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16. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg 2018;100:251-63.
17. Wang CJ. An overview of shock wave therapy in musculoskeletal disorders. Chang Gung Med J 2003;26:220-32.
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21. Yee CH, Chan ES, Hou SS, Ng CF. Extracorporeal shockwave therapy in the treatment of erectile dysfunction: A prospective, randomized, double-blinded, placebo controlled study. Int J Urol 2014;21:1041-5.
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How to Cite this article: Eisner C, Salas M, Moya D | Fundamentals of the Treatment of Male Erectile Dysfunctions with Low Intensity Shockwaves. | Journal of Regenerative Science | Dec 2021; 1(1): 26-29.

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Non Invasive Phisical Physical Regenerative Therapies: Laser therapy, Mechanism of Action and Results

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 21-25 | W. Leonardo Guiloff , Ondrej Prouza , Dragana Žarković. DOI: 10.13107/jrs.2021.v01.i01.013

Author: W. Leonardo Guiloff [1], Ondrej Prouza [2], Dragana Žarković [2]

[1] Department of Orthopedic Surgery of Davila Clinic, Santiago Chile, Past President Onlat-Achitoc, Santiago, Chile.

[2] Department of Anatomy and Biomechanics, Faculty of Physical Education and Sports, Charles
University, Prague, Czech Republic.

Address of Correspondence
Dr. W. Leonardo Guiloff, MD
Department of Orthopedic Surgery of Davila Clinic, Santiago Chile, Past President Onlat-Achitoc, Santiago, Chile.
E-mail: lguiloff@davila.cl

Abstract

Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) have emerged as a therapeutic alternative suitable for a wide range of medical conditions. The main advantage of high-intensity laser over LLLT is its ability to deliver a much higher dose in a shorter time while achieving deeper penetration into the affected tissue and producing a thermal effect. Although HILT, provides very satisfactory clinical results, more clinical research is require to justify its massive use.
Keywords: Low-level laser therapy, High-level laser therapy, Biostimulation, Phototherapy.

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How to Cite this article: Guiloff WL, Prouza O, Žarković D | Non-Invasive Physical Regenerative Therapies: Laser therapy, Mechanism of Action and Results. | Journal of Regenerative Science | Dec 2021; 1(1): 21-25.

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The Sports, Ultrasound, Biologics, and Arthroscopy Protocol in the New Era of Orthopaedic Sports Injuries Treatments

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 16-20 | Bernáldez Domínguez Pedro, Dallo Lazzarini Ignacio. DOI: 10.13107/jrs.2021.v01.i01.011

Author: Bernáldez Domínguez Pedro [1], Dallo Lazzarini Ignacio [1]

[1] Department of Orthopaedic Surgery and Sports Medicine, SportMe Medical Center, Unit of Biological Therapies and Ultrasounds, Seville, Spain.

Address of Correspondence
Dr. Bernáldez Domínguez Pedro, MD. PhD
Tabladilla, 2, 41013, Seville, Spain.
E-mail: pedrobernaldez@gmail.com

Abstract

In the new era of sports traumatology, the union of anatomical, biomechanical, and functional knowledge, together with an adequate clinical examination and complemented with ultrasound studies, arthroscopic surgery, and conventional surgery, makes us understand the pathology, in a new and modern way, of the locomotor system, such as the muscle, tendon, ligament, menisci, capsule, synovial membrane, as well as bone and cartilage pathologies. Biological therapies have shown a good result for soft tissue in chronic pathology that can be applied in an ultrasound guided manner to treat tendinopathy of the Achilles, patellar, and quadriceps tendons, also at the elbow and shoulder level. It is striking to highlight the good results of this biological therapy with platelet-rich plasma for degenerative joint diseases in patients with moderate osteoarthritis. In cases in which conservative or biological therapies have not had their effect, we will generally indicate surgery, in most cases arthroscopically if it is joint pathology. This indication will be mandatory, especially in joint instability cases where we will require stabilizing surgery. We emphasize the importance of multidisciplinary teams where there must be a sports doctor, a sports traumatologist, a physiotherapist, a functional trainer, a podiatrist, biomechanics specialist, and other professionals that surround the athlete, such as the nutritionist, the psychologist so that the athlete has comprehensive assistance and is always well cared for. Together, these concepts make a personalized approach named the Sports, Ultrasound, Biologics, and Arthroscopy protocol to improve clinical results, shorten recovery times, and considerably reduce healthcare costs.
Keywords: Sports, Ultrasound, Biologics, Arthroscopy protocol, Sports medicine, Ultrasound-guided therapies, Biological therapies, Arthroscopy.

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How to Cite this article: Pedro BD, Ignacio DL | The Sports, Ultrasound, Biologics, and Arthroscopy Protocol in the New Era of Orthopaedic Sports Injuries Treatments. | Journal of Regenerative Science | Dec 2021; 1(1): 16-20.

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Shockwave Therapy and Anesthesia: What Evidence is there?

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 13-15 | Paulo Roberto Dias Santos, Bruno Schiefer Dos Santos, Nacime Salomao Barbachan Mansur DOI: 10.13107/jrs.2021.v01.i01.009

Author: Paulo Roberto Dias Santos [1], Bruno Schiefer Dos Santos [1], Nacime Salomao Barbachan Mansur [1,2]

[1] Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

[2] Department of Orthopedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, Iowa.

 

Address of Correspondence:
Dr. Nacime Salomao Barbachan Mansur, MD, PhD.
Departamento de Ortopedia e Traumatologia, Disciplina de Ortopedia e Traumatologia, Escola Paulista de Medicina – Universidade Federal de São Paulo, Brazil.
E-mail: nacime@uol.com.br

Abstract

Introduction: The use of anesthetics on extracorporeal shockwave therapy (ESWT) for musculoskeletal disorders is a matter of debate. Although widely performed, especially on focal procedures, its scientific background is sparse. This study aims to review the current evidence
on the use of anesthetics in ESWT.
Methods: A literature review of the PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases was performed. Studies assessing or comparing the use of any type of anesthetic in any form of shockwave therapy were collected.

Results: After inclusion and exclusion criteria assessment, a total of seven studies were found to directly address the subject and only four were original articles.
Conclusion: The produced evidence is small and lacks methodological quality. These facts support the necessity for new studies using the present technology to determine the real effect of anesthetics on ESWT.

Level of Evidence: Level V. Literature Review

Keywords: Shock waves, Radial pressure waves, Quality standards

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How to Cite this article: Santos PRD, Dos Santos BS, Mansur NSB | Shockwave therapy and anesthesia: What evidence is there? | Journal of Regenerative Science | December 2021;1(1):13-15.

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Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 9-12 | José Eid, Daniel Moya DOI: 10.13107/jrs.2021.v01.i01.007

Author: José Eid [1], Daniel Moya [2]

[1] Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.

[2] Department of Orthopaedic, Servicio de Ortopedia y Traumatología, Hospital Británico de Buenos Aires.

Address of Correspondence:
Dr. José Eid, MD.
Médico Assistente do corpo clínico do Hospital Hcor São Paulo, Brazil.
E-mail: j.eid@uol.com.br

Abstract

Focused shockwaves and radial pressure waves are safe and effective if used correctly. Nevertheless, poor results and complications have been described due to missdiagnosis and technical errors. The aim of this review is to introduce the basic principles of quality and technical recommendations for each method.

Keywords: Shock waves, Radial pressure waves, Quality standards

Reference:

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How to Cite this article: Eid J, Moya D | Quality Standards and Techniques for the Application of Focused Shockwaves and Radial Pressure Waves in Musculoskeletal Disorders. | Journal of Regenerative Science | December 2021; 1(1): 9-12.

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Ultrasound Intervention Techniques in Patellar Tendinopathy: A Review

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 35-38 | Paul German Terán, Estefania Anabel Lozada, Juan Felipe Giraldo. DOI: 10.13107/jrs.2021.v01.i01.019

Author: Paul German Terán [1], Estefania Anabel Lozada [1], Juan Felipe Giraldo [2]

[1] Traumatología y Ortopedia, Centro de Especialidades Ortopédicas, Quito, Ecuador.

[2] Medicina del Deporte, Instituto Colombiano del Dolor INCODOL, Medellín, Antioquia, Colombia.

 

Address of Correspondence
Dr. Paul German Terán MD,
Traumatología y Ortopedia, Centro de Especialidades Ortopédicas, Quito, Ecuador.
E-mail: paulteranmd@gmail.com

Abstract

Patellar tendinopathy is a very common, yet very difficult pathology to treat. Its’ frequency in elite athletes, especially in jumping sports, can go as high as 14%. Recently it has been suggested that chronic tendinopathy may be an active process of ongoing tendon degeneration bearing close relation with inflammation-mediated responses, the intensity of pain in patellar tendinopathy appears to have a stronger relation with the number of newly formed blood vessels observed on Doppler ultrasound. This article is a descriptive review of the available information which was obtained during a 1-month period (September 2021) and the following search keywords were used: interventional ultrasonography; patellar ligament; tendinopathy. Based on the information obtained, a total of 787 articles were revied, mainly published in the last 10 years in Pubmed, Medline, and SciELO databases; out of these, a total of 15 articles were used as citations. Even though conservative treatment is preferred as a first-line treatment, if, during a 6-month period it fails, then surgical treatment is proposed; however, recovery time is a crucial issue for elite athletes. Treatment by ultrasound-guided interventionism is presented as an effective alternative and allows athletes to return to their regular activities in less time, with optimal results. In the literature there are not many articles that describe the various techniques of ultrasound-guided interventionism for the treatment of patellar tendinopathy, thus, we have carried out this bibliographic review.

Keywords: Interventional ultrasonography, Patellar ligament, Tendinopathy.

References:

1. Maffulli N, Del Buono A, Oliva F, Testa V, Capasso G, Maffulli G. High-volume image-guided injection for recalcitrant patellar tendinopathy in athletes. Clin J Sport Med 2016;26:12-6.
2. Willberg L, Sunding K, Forssblad M, Fahlström M, Alfredson H. Sclerosing polidocanol injections or arthroscopic shaving to treat patellar tendinopathy/jumper’s knee? A randomised controlled study. Br J Sports Med 2011;45:411-5.
3. Abat F, Diesel WJ, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Effectiveness of the intratissue percutaneous electrolysis (EPI®) technique and isoinertial eccentric exercise in the treatment of patellar tendinopathy at two years follow-up. Muscles Ligaments Tendons J 2014;4:188-93.
4. Moura JL, Abreu FG, Queirós CM, Pisanu G, Clechet J, Vieira TD, et al. Ultrasound-guided electrocoagulation of neovessels for chronic patellar tendinopathy. Arthrosc Tech 2020;9:e803-7.
5. Fogli M, Giordan N, Mazzoni G. Efficacy and safety of hyaluronic acid (500-730kDa) ultrasound-guided injections on painful tendinopathies: A prospective, open label, clinical study. Muscles Ligaments Tendons J 2017;7:388-95.
6. Lee WC, Zhang ZJ, Masci L, Ng GY, Fu SN. Alterations in mechanical properties of the patellar tendon is associated with pain in athletes with patellar tendinopathy. Eur J Appl Physiol 2017;117:1039-45.
7. Rodriguez-Merchan EC. The treatment of patellar tendinopathy. J Orthop Traumatol 2013;14:77-81.
8. Wang JH, Iosifidis MI, Fu FH. Biomechanical basis for tendinopathy. Clin Orthop Relat Res 2006;443:320-32.
9. Hall MM, Rajasekaran S. Ultrasound-guided scraping for chronic patellar tendinopathy: A case presentation. PM R 2016;8:593-6.
10. Masci L, Alfredson H, Neal B, Bee WW. Ultrasound-guided tendon debridement improves pain, function and structure in persistent patellar tendinopathy: Short term follow-up of a case series. BMJ Open Sport Exerc Med 2020;6:e000803.

11. Nielsen TG, Miller LL, Mygind-Klavsen B, Lind M. High-volume image-guided injection in the chronic recalcitrant non-insertional patellar tendinopathy: A retrospective case series. J Exp Orthop 2020;7:80.
12. Crisp T, Khan F, Padhiar N, Morrissey D, King J, Jalan R, et al. High volume ultrasound guided injections at the interface between the patellar tendon and Hoffa’s body are effective in chronic patellar tendinopathy: A pilot study. Disabil Rehabil 2008;30:1625-34.
13. Morton S, Chan O, King J, Perry D, Crisp T, Maffulli N, et al. High volume image-guided Injections for patellar tendinopathy: A combined retrospective and prospective case series. Muscles Ligaments Tendons J 2014;4:214-9.
14. Balius R, Díaz FJ. Ecografía Intervencionista en Traumatología del Deporte. Madrid: Editorial Médica Panamericana; 2015. p. 146.
15. Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 2015;23:1046-52.

 

How to Cite this article: Terán PG, Lozada EA, Giraldo JF | Ultrasound intervention techniques in patellar tendinopathy: A review. | Journal of Regenerative Science | Dec 2021; 1(1): 35-38.

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New Trends in Ultrasound-Guided Musculoskeletal Injuries Approaches

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Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 30-34 | Bernáldez Domínguez Pedro, Dallo Lazzarini Ignacio. DOI: 10.13107/jrs.2021.v01.i01.017

Author: Bernáldez Domínguez Pedro [1], Dallo Lazzarini Ignacio [1]

[1] Department of Orthopaedic Surgery and Sports Medicine, SportMe Medical Center, Unit of Biological Therapies, Seville, Spain.

 

Address of Correspondence
Dr. Bernáldez Domínguez Pedro, MD
Tabladilla, 2, 41013, Seville, Spain.
E-mail: pedrobernaldez@gmail.com

Abstract

The ultrasound not only allows us to diagnose musculoskeletal injuries but is also a fantastic tool to assist us when performing different therapies on the tissues. Multiple studies compare the classic blind versus ultrasound-guided infiltrations, with a significant difference in the results. In this article, we present the different indications for ultrasound-guided therapies, including ultrasound-guided local infiltration, percutaneous needle tenotomy, intracapsular hydrodilatation, hydrodissection, high-volume injection, percutaneous needle scraping and ultrasound-guided surgery (EAS). We describe the techniques, their advantages, and disadvantages, as well as possible complications. These procedures require a good learning curve, but once achieved, it will allow us to use them to obtain good clinical results, and in many cases avoiding the operating room. We have included these therapies in the so-called “SUBA Protocol” that includes the application of the concepts of modern Sports trauma, the use of musculoskeletal Ultrasounds, consider Biological therapies as one more tool in the therapeutic arsenal, and finally, the use of Arthroscopic surgeries, minimally invasive procedures with minor tissue damage.

Keywords: Musculoskeletal ultrasound, Ultrasound-guided therapies, Percutaneous needle tenotomy, Intracapsular hydrodilatation,
Hydrodissection, Percutaneous needle scraping, Ultrasound-guided surgery, SUBA protocol.

References:

1. Domínguez B, Martos TA. El ecógrafo: El fonendo del Traumatólogo: Utilidad diagnostica y terapéutica. Rev S Traum Ort 2017;34:17-26.
2. De Zordo T, Lill SR, Fink C, Feuchtner GM, Jaschke W, Bellmann-Weiler R, et al. Real-time sonoelastography of lateral epicondylitis: Comparison of findings between patients and healthy volunteers. AJR Am J Roentgenol 2009;193:180-5.
3. Nazarian LN. The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI. AJR Am J Roentgenol 2008;190:1621-6.
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5. Daniels EW, Cole D, Jacobs B, Phillips SF. Existing evidence on ultrasound-guided injections in sports medicine. Orthop J Sports Med 2018;6:2325967118756576.
6. Peck E, Jelsing E, Onishi K. Advanced ultrasound-guided interventions for tendinopathy. Phys Med Rehabil Clin N Am 2016;27:733-48.
7. Hall MM, Rajasekaran S. Ultrasound-guided scraping for chronic patellar tendinopathy: A case presentation. PM R 2016;8:593-6.
8. Patel R, Urits I, Wolf J, Murthy A, Cornett EM, Jones MR, et al. A comprehensive update of adhesive capsulitis and minimally invasive treatment options. Psychopharmacol Bull 2020;50 4 Suppl 1:91-107.
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10. Boesen AP, Hansen R, Boesen MI, Malliaras P, Langberg H. Effect of high-volume injection, platelet-rich plasma, and sham treatment in chronic midportion achilles tendinopathy: A randomized double-blinded prospective study. Am J Sports Med 2017;45:2034-43.

11. Tafti D, Byerly DW. Ultrasound Guided Barbotage. Treasure Island, FL: StatPearls Publishing; 2021.
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13. Gao L, Madry H, Chugaev DV, Denti M, Frolov A, Burtsev M, et al. Advances in modern osteotomies around the knee: Report on the association of sports traumatology, arthroscopy, orthopaedic surgery, rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017. J Exp Orthop 2019;6:9.
14. Sabeti-Aschraf M, Lemmerhofer B, Lang S, Schmidt M, Funovics PT, Ziai P, et al. Ultrasound guidance improves the accuracy of the acromioclavicular joint infiltration: A prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2011;19:292-5.
15. Berkoff DJ, Miller LE, Block JE. Clinical utility of ultrasound guidance for intra-articular knee injections: A review. Clin Interv Aging 2012;7:89-95.
16. Aly AR, Rajasekaran S, Ashworth N. Ultrasound-guided shoulder girdle injections are more accurate and more effective than landmark-guided injections: A systematic review and meta-analysis. Br J Sports Med 2015;49:1042-9.
17. Wu T, Song HX, Dong Y, Li JH. Ultrasound-guided versus blind subacromial-subdeltoid bursa injection in adults with shoulder pain: A systematic review and meta-analysis. Semin Arthritis Rheum 2015;45:374-8.
18.Hoeber S, Aly AR, Ashworth N, Rajasekaran S. Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: A systematic review and meta-analysis. Br J Sports Med 2016;50:392-6.
19. Domínguez MP. Bridging the Gap between Surgical and Conservative Treatment. The SUBA Protocol (Sports, Ultrasound, Biologics, Arthroscopy). TOBI (The Orthobiologic Institute) Conference; 2021.

 

How to Cite this article: Pedro BD, Ignacio DL | New Trends in Ultrasound-Guided Musculoskeletal Injuries Approaches. | Journal of Regenerative Science | Dec 2021; 1(1): 30-34.

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