Percutaneous Ultrasound-Guided Musculoskeletal Applications of Autologous Bone Marrow Aspirate Concentrate: Preliminary Experience From a Single Institution.

Autor: Garwood ER; Department of Radiology, NYU Langone Medical Center/Hospital for Joint Disease, New York, NY., Burke CJ; Department of Radiology, NYU Langone Medical Center/Hospital for Joint Disease, New York, NY., Jazrawi LM; Department of Orthopaedic Surgery, NYU Langone Medical Center/Center for Musculoskeletal Care, New York, NY., Adler RS; Department of Radiology, NYU Langone Medical Center/Hospital for Joint Disease, New York, NY.
Jazyk: angličtina
Zdroj: Ultrasound quarterly [Ultrasound Q] 2018 Dec; Vol. 34 (4), pp. 278-284.
DOI: 10.1097/RUQ.0000000000000339
Abstrakt: Emerging musculoskeletal applications for local administration of autologous bone marrow aspirate concentrate (BMAC) include treatment of fractures, osteonecrosis, osteochondral injuries, osteoarthritis, ligament injury, tendon injury, and tendonopathies. Ultrasound-guided technique for various BMAC injection sites is detailed in this technical report and our preliminary clinical experience outlined.Five patients, 1 woman and 4 men, were treated with 6 peri/intratendinous (n = 4) or intraarticular (n = 2) BMAC injections between July 5, 2015 and December 31, 2016 for the clinical indications of common hamstrings origin tendinosis (n = 4), hip labral tear (n = 1), and osteochondral lesion of the talus (n = 1).All procedures were technically successful, with BMAC locally administered to the therapeutic target and no procedural complications observed. Clinical follow-up was available for 5 of 6 procedures. Four of 5 injections resulted in self-reported symptomatic improvement (clinical follow-up range, 2-12 months). One 72-year-old man with right common hamstrings origin tendinosis reported no improvement after BMAC injection.The technology is now available to support ultrasound-guided, autologous BMAC administration by the musculoskeletal interventionalist for common indications. Our initial clinical experience is consistent with early reports in the literature. This technique is well tolerated by symptomatic patients on an outpatient basis, and rates of self-reported symptomatic relief are high. Mechanism of action, long-term safety, and long-term clinical efficacy remain largely undefined.
Databáze: MEDLINE