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SPORTS MEDICINE

Regenerative Sports Medicine

Regenerative sports medicine refers to the medical-surgical process of “regenerating” tissues by harvesting, processing, and re-inserting other cells taken from different tissues. The term regenerative medicine is commonly used to refer to medical strategies in research or clinical settings that make use of the extraordinary potential of a particular type of cells, stem cells.

Regenerative Medicine is a rapidly growing multi-disciplinary field involving not only medical but also human and engineering sciences that seeks to develop functional cells, tissues, or organ replacements for the purpose of repairing or improving biological functions lost due to congenital diseases, trauma, and consequences of aging. Stem cells offer unprecedented hope for treating and perhaps healing severely damaged tissues that cannot be saved by even the most advanced pharmacological or surgical treatments. This prospect has paved the way for a new paradigm in the management of complex diseases, termed precisely “Regenerative Medicine,” which has the potential to heal diseases or traumas that are now chronic and to aid healthy and active aging, with exceptional socioeconomic spin-offs.

In the field of sports, regenerative medicine is of fundamental use, not only for autonomous tissue reconstruction but also for tissue preservation: training, stress, loads and any trauma to the musculoskeletal system and neighboring soft tissues creates accentuated degeneration.

The increase in average life span means that there is a need for a longer period of work activity and an improvement in physical and mental efficiency. Thus arises the need to understand very carefully that the tissues from which our bodies are composed are not eternal and immortal but may be undergoing degeneration and wear and tear just when we do not expect it.

Preserving, replacing, or regenerating tissues through the use of stem cells (especially from adipose tissue) offers unprecedented hope for the treatment and healing of severely damaged tissues that are difficult to save by more advanced pharmacological, physiotherapeutic, or surgical treatments.

The main sources of mesenchymal stem cells (MSCs) are: bone marrow, peripheral blood, umbilical cord, and adipose tissue. In particular, adipose tissue has easier access, less pain in harvesting (mini-liposuction), minimal invasiveness, its use is independent of blood centers, but most importantly, it is richer in MSCs. Pericytes, hADSCs, etc. Stem application promotes regeneration of degenerated or damaged tissue: on the recipient tissue both has a trophic effect, anti-inflammatory, anti-infective and revascularization effect.

The vasculo-stromal niche preserved by cell harvesting in the donor area with high concentrations of mesenchymal stem cells may find other applications in the areas of ulcer healing, gynecology, urology, proctology, otolaryngology, reconstructive plastic surgery, orthopedics as well as cosmetic surgery and sports medicine.

 
 

SPORTS MEDICINE – HOW IT WORKS

 

Grafting platelet factors to the joint stimulates cells deputed to tendon and cartilage regeneration.

To date, therefore, we possess a state-of-the-art treatment that allows us to preserve and treat the deterioration of joint tissues, certainly due both to ‘advancing age but also from excessive joint use.

The first effect is that of a marked improvement in the biological and histological condition of knee or shoulder cartilage and joint tissues, just as in muscle tissues prp relieves pain and reduces healing time; however, if we treat a muscle injury, our goal is to improve healing; if, on the other hand, we treat degenerative arthritic syndromes, such as those affecting knee cartilage, the first goal is to limit the algic symptoms; this is also accomplished by the consistency of prp, which is autologous viscous fluid that is injected into the joint.

In recent years, impressive clinical effects have been shown (especially in patients in whom PRP did not demonstrate satisfactory clinical results) by micronized adipose tissue grafting with complete preservation of the vascular-stromal niche (SVF): with fat harvesting, its special processing (which absolutely prohibits centrifugation) and injection of the same into the joint cavity, a very strong cartilage regenerative effect is witnessed.

Researchers to date are still studying whether the regeneration effect is due to cellular differentiation of these adipose tissue-derived cells, or whether the vascular-stromal niche (SVF) releases particular factors that are able to stop inflammation and redistribute cellular architectural harmony that provides for repair of damaged tissue (see next chapter: Human Adipose Stem Cells with Adipose Microfractured Clusters and Preserved Stroma-Vascular Fraction).

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