Biologic therapies for foot and ankle injuries

ABSTRACT

Introduction: The use of orthobiologics as supplemental treatment for foot and ankle pathologies have increased in the past decades. They have been used to improve the healing of bone and soft tissue injuries. There have been several studies that examined the use of biologics for knee and hip pathologies but the foot and ankle construct has unique features that must be considered.

Areas covered: The biologics for foot and ankle injuries that are covered in this review are platelet-rich plasma (PRP), stem cells, growth factors, hyaluronic acid, bone grafts, bone substitutes, and scaffolds. These modalities are used in the treatment of pathologies related to tendon and soft tissue as well as cartilage.

Expert opinion: The utilization of biological adjuncts for improved repair and regeneration of ankle injuries represents a promising future in our efforts to address difficult clinical problems. The application of concentrated bone marrow and PRP each represents the most widely studied and commonly used injection therapies with early clinical studies demonstrating promising results, research is also being done using other potential therapies such as stem cells and growth factors; further investigation and outcome data are still needed.

KEYWORDS:

• Foot and ankle
• BMAC
• stem cells
• PRP
• tendons
• cartilage

Article highlights box

• A breadth of orthobiologics has emerged to improve the healing of foot and ankle injuries?

• Current clinical therapies are platelet-rich plasma, stem cells, growth factors, hyaluronic acid, bone grafts, bone substitutes, and scaffolds, of which PRP and stem cells are at the forefront due to their autologous nature.

• PRP therapy is an attractive and popular option for the treatment of injured tendon, plantar fascitis, and cartilage injuries especially when combined with other repair enhancing factors. capability.

• Bone marrow aspirate concentrate has utility in Achilles tendinopathies and other pathologies due to its efficacy in controlling inflammation, reducing fibrosis, and cell recruitment.

• Scaffold based treatments have been used in cartilage related pathologies and have resulted in lower pain scores compared to controls. Platelet-derived growth factorshave been shown to recruit inflammatory cells and stimulate angiogenesis in human trials.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.