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Book

Regenerative Therapy in Pain

Nwadi Igwe  1 , Neil C. Patel  2 , Tabish Aijaz  3
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
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Book

Regenerative Therapy in Pain

Nwadi Igwe et al.
Free Books & Documents

Excerpt

Regenerative medicine has been in existence for many decades, and many therapies have received United States Food and Drug Administration (FDA) approval for wound healing and orthopedic applications. Regenerative medicine is a field that applies biological science principles to promote regeneration by delivering or replacing organs, cells, or tissues in an attempt to restore diseased and damaged tissues and whole organs. There are four main avenues of therapies in regenerative medicine: viscosupplementation, platelet-rich plasma, stem cells, and prolotherapy.

Viscosupplementation: Injection of hyaluronic acid into intra-articular space can restore the viscosity and elasticity of osteoarthritic synovial fluid. HA plays an essential role in shock absorption, lubrication, and the visco-elastic nature of the synovial fluid.

Prolotherapy: Prolotherapy is the injection of a solution to rehabilitate an incompetent structure and promote sclerosis at the injection site. Prolotherapy differs from other regenerative medicine techniques because the injectate lacks a biological component. The most commonly used injectate for prolotherapy is hypertonic dextrose which causes a stimulation of the body’s inflammatory cascade.

Platelet-rich plasma: Platelet-rich plasma releases bioactive proteins that stimulate the body’s ability to heal due to its regenerative, analgesic, and anti-inflammatory properties.

Mesenchymal Stem Cell

According to the International Society for Cellular Therapy, the criteria for cells to be considered mesenchymal stem cells include:

  1. Plastic adherence when maintained under standard culture

  2. Expression of CD73, CD 90, and CD 105 and not the expression of CD11b, CD14, CD19, CD34, CD45, or HLA-DR

  3. Ability to differentiate into osteoblasts, chondroblasts, and adipocytes in vitro

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Conflict of interest statement

Disclosure: Nwadi Igwe declares no relevant financial relationships with ineligible companies.

Disclosure: Neil Patel declares no relevant financial relationships with ineligible companies.

Disclosure: Tabish Aijaz declares no relevant financial relationships with ineligible companies.

References

    1. Mao AS, Mooney DJ. Regenerative medicine: Current therapies and future directions. Proc Natl Acad Sci U S A. 2015 Nov 24;112(47):14452-9. - PMC - PubMed
    1. Henrotin Y, Raman R, Richette P, Bard H, Jerosch J, Conrozier T, Chevalier X, Migliore A. Consensus statement on viscosupplementation with hyaluronic acid for the management of osteoarthritis. Semin Arthritis Rheum. 2015 Oct;45(2):140-9. - PubMed
    1. Balazs EA, Denlinger JL. Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl. 1993 Aug;39:3-9. - PubMed
    1. Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev. 2007 Apr 18;2007(2):CD004059. - PMC - PubMed
    1. Siadat AH, Isseroff RR. Prolotherapy: Potential for the Treatment of Chronic Wounds? Adv Wound Care (New Rochelle) 2019 Apr 01;8(4):160-167. - PMC - PubMed

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