Orthobiologics and their role in cartilage injury – Prof Cathal Moran SSC.

Welcome to ‘On the Table’ – Sports Surgery Clinic’s orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC.

The purpose of the podcast is to explore the reasons behind making a decision to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.

In Episode Three, we are delighted to speak to Professor Cathal Moran, Consultant Orthopaedic Surgeon and Professor of Sports Medicine and Orthopaedics, Trinity College Dublin.

This episode focuses on the topic of orthobiologics in their role in cartilage injury.

Shownotes:

04:20
What does orthobiologics refer to?

06:05
What is cartilage in the joint, and how is it injured?

07:23
What treatment options currently exist for chondral lesions, and what guidelines are there on size and grading?

08:11
Osteoarthritis and links to chondral damage?

09:19
What is the decision-making process on operative choice between microfracture, and autograft and allografting?

11:25
How do you decide with the patient what works?

14:24
Why does chondral surface not regrow?

15:48
We hear of patients flying to specialist centres around the world for treatment… what are they offering?

20:48
What is a stem cell? We can obtain the from fat and bone marrow – which is the favoured approach in the trials right now?

24:01
Platelet-rich plasma trials on osteoarthritis in the knee, what does the evidence show? Where does stem cell research take us?

28:40
There is some promising work from Stanford on magnetised mesenchymal stem cells being pulled into lesions.

30:30
What is the latest work from Trinity and the Bioengineering department trials into stem cell plugs and inclusion criteria?

33:19
There a plethora of stem cell clinics springing up – is this something that can benefit me right now or is it smoke and mirrors.

Link to the metanalysis mentioned in the podcast

Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials.
Dai WL, Zhou AG, Zhang H, Zhang J. Arthroscopy. 2017 Mar;33(3):659-670.e1.
Xia T, Yu F, Zhang K, et al. The effectiveness of allogeneic mesenchymal stem cells therapy for knee osteoarthritis in pigs. Ann Transl Med. 2018;6(20):404. doi:10.21037/atm.2018.09.55

Selected papers from Professor Moran

Anterior Cruciate Ligament Reconstruction with Platelet-Rich Plasma: A Systematic Review of Randomized Control Trials. Davey MS, Hurley ET, Withers D, Moran R, Moran CJ. Arthroscopy. 2020 Apr;36(4):1204-1210.

Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases. Montgomery C, Blackburn J, Withers D, Tierney G, Moran C, Simms C.Br J Sports Med. 2018 Aug;52(15):994-1001. doi: 10.1136/bjsports-2016-096425. Epub 2016 Dec 30.

Translation of science to surgery: linking emerging concepts in biological cartilage repair to surgical intervention.Moran CJ, Shannon FJ, Barry FP, O’Byrne JM, O’Brien T, Curtin W. J Bone Joint Surg Br. 2010 Sep;92(9):1195-202. doi: 10.1302/0301-620X.92B9.23651. Review.

Gene-modified mesenchymal stem cells express functionally active nerve growth factor on an engineered poly lactic glycolic acid (PLGA) substrate.
Rooney GE, Moran C, McMahon SS, Ritter T, Maenz M, Flügel A, Dockery P, O’Brien T, Howard L, Windebank AJ, Barry FP.
Tissue Eng Part A. 2008 May;14(5):681-90.

About Professor Moran

Professor Moran has personal website www.cathaljmoran.com, and you can follow Cathal on twitter @CMoransurgeon

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