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6 mesi ago News

ORTOGERIATRIA: utilizzo di cellule staminali per il trattamento di disturbi muscolo-scheletrici

Giunge alla nostra attenzione la paziente P.A. di 64 anni affetta da una invalidante gonalgia bilaterale con gravi limitazioni nella vita quotidiana e zoppia antalgica di grado severo tale  da dovere utilizzare 2 bastoni canadesi per deambulare. Ha praticato da 5-6 anni cure tramite infiltrazioni con acido ialuronico e cortisonici, fisiochinesiterapia  e  numerosi anti-infiammatori senza alcun beneficio.

Decide di rivolgersi presso gli ambulatori della Clinica Ruesch di Napoli per una  visita ortogeriatrica fissando un appuntamento con il Prof. Rinaldo Giancola, attuale Coordinatore dell’Ortogeriatria del Gruppo Villa Maria, past president della Società Italiana di  Traumatologia e Ortopedia Geriatrica (AITOG) . Alla paziente viene proposto  un innovativo intervento chirurgico di artroscopia bilaterale e introduzione di concentrato di tessuto adiposo prelevato dall’ adipe addominale secondo metodica LIPOGEMS.

ANAMNESI

All’anamnesi la paziente riporta una familiarità per malattia cardiovascolari, non fumatrice, rinite allergica stagionale, riferisce allergia alla classe dei macrolidi e cefalosporine, presenta una  spondilosi vertebrale  con riduzione degli spazi intersomatici  da d12 ad L3, pregressa  colecistectomia nel 2000 sempre presso Clinica Ruesch.

Esame obiettivo ginocchio destro e sinistro: varismo bilaterale, discreto versamento articolare a dx, limitazione dei movimenti nella flessione estensione per algia all’emirima soprattutto mediale a dx, e scarsa autonomia alla deambulazione.

Praticava  profilassi anti-allegica preoperatoria 2 giorni prima dell’intervento.

 

INTERVENTO CHIRURGICO di ARTROSCOPIA BILATERALE

Il Prof. Giancola Rinaldo con la sua equipe in data 04/05/17 effettuava un intervento artroscopico bilaterale riscontrando una condropatia bilaterale di 2°/3°  con una lesione complessa del menisco mediale a dx che veniva trattata mediante meniscectomia selettiva. Mediante il sistema Lipogems venivano prelevati dal tessuto adiposo addominale le cellule staminali mesenchimali poi infiltrate a livello articolare bilateralmente.

 

POST INTERVENTO

Il giorno successivo la paziente non riferiva dolore né versamento articolare e pertanto veniva concesso il carico totale  con ausilio  di due  bastoni canadesi e dimessa con programma fisioterapico (Kinetek) e progressivo abbandono dei bastoni entro una settimana. Attualmente la paziente deambula autonomamente senza riscontrare dolore al cammino. Durante il decorso operatorio e post operatorio la paziente ha avuto un alto grado di soddisfazione da parte della metodica e benefici clinici di tipo obiettivo.

 

IN COSA CONSISTE IL METODO LIPOGEMS

Il sistema LIPOGEMS è un kit monouso per la lipoaspirazione, preparazione ed innesto di cellule staminali mesenchimali da tessuto adiposo prelevato dallo stesso paziente. L’intera procedura avviene in un unico tempo. Il prodotto ottenuto con la tecnica LIPOGEMS conserva le caratteristiche biologiche del tessuto connettivo adiposo naturale ma, grazie alle ridotte dimensioni,  può essere iniettato attraverso aghi sottili con minimo traumatismo.

Le cellule mesenchimali si stanno rivelando efficaci per il trattamento di lesioni a tendini, legamenti, cartilagine e osso, soprattutto nelle zone in cui il corpo è lento a rigenerarsi o guarire a causa della mancanza di flusso di sangue. L’utilizzo intra-articolare  si è dimostrato sicuro in modelli animali ed efficace dal punto di vista rigenerativo per la cartilagine. In pazienti con osteoartrosi grave, la stessa procedura ha mostrato una significativa riduzione del dolore sia a riposo che in movimento, una diminuzione della rigidità e un aumento della mobilità.

Il tessuto adiposo micro-frammentato può avere un’azione attraverso due differenti meccanismi:

1. l’azione meccanica viscosupplementativa del tessuto adiposo nello spazio articolare come lubrificante
2. l’effetto trofico e paracrino delle MSC contenute del tessuto adiposo micro-frammentato, le quali hanno inoltre proprietà anti-infiammatorie, e possono promuovere la rigenerazione del tessuto articolare cartilagineo.

E’ una tecnologia di nuova concezione in grado di massimizzare l’azione rigenerativa del tessuto adiposo attraverso la micro-frammentazione dello stesso. 

Dopo la procedura si consiglia un periodo di riposo di circa 24 ore per ridurre la possibilità di processi infiammatori ed è consigliato applicare ghiaccio più volte al giorno.

 

Il Sistema LIPOGEMS ha ottenuto la certificazione negli USA ed è al tempo stesso un permesso di importazione dei dispositivi medici negli Stati Uniti e ha una autorizzazione alla vendita in America rilasciato dalla Food Drug Amministration. L’IRCCS Istituto Ortopedico Rizzoli di Bologna ha attualmente approvato un protocollo sperimentale basato sull’uso di Lipogems come procedura trapiantologica intra-articolare.

 

BIBLIOGRAFIA

Bianchi F.*, Maioli M., Leonardi E., Olivi E., Pasquinelli G., Valente S., Mendez A.J., Ricordi C., Raffaini M., Tremolada C., Ventura C.«A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in pericyte-like elements by mild mechanical forces from human lipoaspirates.».Cell Transplant. 2013;22(11):2063-77. doi: 10.3727/096368912X657855. Epub 2012 Oct

*Laboratory of Molecular Biology and Stem Cell Engineering-National Institute of Biostructures and Biosystems, Bologna, Italy.

Carelli S.*, Messaggio F., Canazza A., Hebda D., Caremoli F., Latorre E., Grimoldi M.G., Colli M., Bulfamante G., Tremolada C.

«Characteristics and Properties of Mesenchymal Stem Cells Derived from Micro-fragmented Adipose Tissue.».

Cell Transplant. 2014 April 29

*Laboratorio di Farmacologia, Dipartimento di Scienze della Salute, Università degli Studi di Milano.

Maioli M.*, Rinaldi S., Santaniello S., Castagna A., Pigliaru G., Delitala A., Bianchi F., Tremolada C., Fontani V., Ventura C.

«Radio electric asymmetric conveyed fields and human adipose-derived cells obtained with a non-enzymatic method and device: a novel approach to multipotency.».

Cell Transplant. 2013 Aug 30. doi: 10.3727/096368913X672037. [Epub ahead of print]

*Laboratory of Molecular Biology and Stem Cell Engineering, National Institute of Biostructures and Biosystems, Bologna, Italy

Tremolada C.*, Palmieri G., Ricordi C.

«Adipocyte transplantation and stem cells: plastic surgery meets regenerative medicine.».

Cell Transplant. 2010;19(10):1217-23. doi: 10.3727/096368910X507187. Epub 2010 May 4. *Istituto Image and San Paolo Hospital, Milan, Italy

Injection of autologous micro-fragmented adipose tissue for the treatment of post-traumatic degenerative lesion of knee cartilage: a case report

  1. Franceschini, C. Castellaneta, G. Mineo 

    CellR4 2016; 4 (1): e1768 
    Orthopaedic and Trauma Department, Istituto Ortopedico “G. Pini”, University of Milan, Milan, Italy 

Dhollander AAM, Verdonk PCM, Lambrecht S, Verdonk R, Elewaut D, Verbruggen G, Almqvist KF. Midterm re- sults of the treatment of cartilage defects in the knee using alginate beads containing human mature allogenic chon- drocytes. Am J Sports Med 2012; 40(1): 75-82.

Benzi R, Marfia G, Bosetti M, Beltrami G, Magri AS, Ver- sari S, Tremolada C. Microfractured lipoaspirate may help oral bone and soft tissue regeneration: a case report. CellR4 2015; 3(3): e1583.

Almqvist KF, Dhollander AAM, Verdonk PCM, Forsyth R, Verdonk R, Verbruggen G. Treatment of cartilage defects in the knee using alginate beads containing human mature al- logenic chondrocytes. Am J Sports Med 2009; 37(10): 1920-1929.

Giori A, Tremolada C, Vailati R, Navone SE, Marfia G, Caplan AI. Recovery of function in anal incontinence after micro-fragmented fat graft (Lipogems®) injection: two years follow up of the first 5 cases. CellR4 2015; 3(2): e1544.

Tremolada C, Palmieri G, Ricordi C. Adipocyte transplan- tation and stem cells: plastic surgery meets regenerative medicine. Cell Transplant 2010; 19(10): 1217-1223.

Cestaro G, De Rosa M, Massa S, Amato B, Gentile M. In- tersphincteric anal lipofilling with micro-fragmented fat tissue for the treatment of faecal incontinence: preliminary results of three patients. Wideochir Inne Tech Maloin- wazyjne 2015; 10(2): 337-341.

Banyard DA, Salibian AA, Widgerow AD, Evans GR. Im- plications for human adipose-derived stem cells in plastic surgery. J Cell Mol Med 2015; 19(1): 21-30.

Raffaini M, Tremolada C. Micro fractured and purified adi- pose tissue graft (Lipogems®) can improve the orthognathic surgery outcomes both aesthetically and in postoperative healing. CellR4 2014; 2(4): e1118.

Chang KA, Lee JH, Suh YH. Therapeutic Potential of Human Adipose-Derived Stem Cells in Neurological Dis- orders. J Pharm Sci 2014; 126(4): 293-301.

Jia HY, Yu JH, Lei TC. The multi-lineage differentiation and angiogenesis ability of adipose-derived adult mes- enchymal stem cells. Clin Lab 2014; 60(10): 1747-1755.

Bianchi F, Olivi E, Baldassarre M, Giannone FA, Laggetta M, Valente S, Cavallini C, Tassinari R, Canaider R, Pasquinelli G, Tremolada C, Ventura C. Lipogems, a new modality of fat tissue handling to enhance tissue repair in chronic hind limb ischemia. CellR4 2014; 2(6): e1289.

Awad HA, Wickham MQ, Leddy HA, Gimble JM, Guilak F. Chondrogenic differentiation of adipose-derived adult stem cells in agarose, alginate, and gelatin scaffolds. Bio- materials 2004; 25(16): 3211-3222.

De Ugarte DA, Morizono K, Elbarbary A, Alfonso Z, Zuk PA, Zhu M, Dragoo JL, Ashjian P, Thomas B, Benhaim P, Chen I, Fraser J, Hedrick MH. Comparison of multi-lin- eage cells from human adipose tissue and bone marrow. Cells Tissues Organs 2003; 174(3): 101-109.

Ruetze M, Richter W. Adipose-derived stromal cells for os- teoarticular repair: trophic function versus stem cell activ- ity. Expert Rev Mol Med 2014; 9,16: e9.

Bianchi F, Maioli M, Leonardi E, Olivi E, Pasquinelli G, Valente S, Mendez AJ, Ricordi C, Raffaini M, Tremolada C, Ventura C. A new nonenzymatic method and device to obtain a fat tissue derivative highly enriched in peri- cyte-like elements by mild mechanical forces from human lipoaspirates. Cell Transplant 2013; 22(11): 2063- 2077.

Huang JI, Zuk PA, Jones NF, Zhu M, Lorenz HP, Hedrick MH, Benhaim P. Chondrogenic potential of multipotential cells from human adipose tissue. Plast Reconstr Surg 2004; 113(2): 585-594.

Maioli M, Rinaldi S, Santaniello S, Castagna A, Pigliaru G, Delitala A, Bianchi F, Tremolada C, Fontani V, Ventura C. Radioelectric asymmetric conveyed fields and human adipose-derived stem cells obtained with a nonenzymatic method and device: a novel approach to multipotency. Cell Transplant 2014; 23(12): 1489-1500.

Seo SS, Kim CW, Jung DW. Management of focal chon- dral lesion in the knee joint. Knee Surg Relat Res 2011; 23(4): 185-196.

Carelli S, Messaggio F, Canazza A, Hebda DM, Caremoli F, Latorre E, Grimoldi MG, Colli M, Bulfamante G, Tremolada C, Di Giulio AM, Gorio A. Characteristics and properties of mesenchymal stem cells derived from micro-fragmented adi- pose tissue. Cell Transplant 2014; 24: 1233-1252.

Garcìa-Contreras M, Messaggio F, Jimenez O, Mendez A. Differences in exosome content of human adipose tissue processed by non-enzymatic and enzymatic methods. CellR4 2014; 3(1): e1423.

Canaider S, Maioli M, Facchin F, Bianconi E, Santaniello S, Pigliaru G, Ljungberg L, Burigana F, Bianchi F, Olivi E, Tremolada C, Biava PM, Ventura C. Human stem cell exposure to developmental stage zebrafish extracts: a novel strategy for tuning stemness and senescence patterning. CellR4 2014; 2(5): e1226.

Ulstein S, Årøen Ar, Røtterud JH, Løken S, Engebretsen L, Heir S. Microfracture technique versus osteochondral autologous transplantation mosaicplasty in patients with articular chondral lesions of the knee: a prospective ran- domized trial with long-term follow-up. Knee Surg Sports Traumatol Arthrosc 2014; 22(6): 1207-1215.

Dhollander AA, Guevara Sanchez VR, Almqvist KF, Verdonk R, Verbruggen G, Verdonk PC. The use of scaffolds in the treatment of osteochondral lesions in the knee: current con- cepts and future trends. J Knee Surg 2012; 25(3): 179-186.

Williams 3rd RJ, Harnly HW. Microfracture: indications, technique, and results. Instr Course Lect 2006; 56: 419- 428.

Zorzi C, Dall’Oca C, Cadossi R, Setti S. Effects of pulsed elec- tromagnetic fields on patients’ recovery after arthroscopic sur- gery: prospective, randomized and double-blind study. Knee Surg Sports Traumatol Arthrosc 2007; 15(7): 830-834.

Behery O, Siston RA, Harris JD, Flanigan DC. Treatment of cartilage defects of the knee: expanding on the existing algorithm. Clin J Sport Med 2014; 24(1): 21-30.

Harris JD, Brophy RH, Siston RA, Flanigan DC. Treatment of chondral defects in the athlete’s knee. Arthroscopy 2010; 26(6): 841-852.

Fini M, Giavaresi G, Carpi A, Nicolini A, Setti S, Giardino R. Effects of pulsed electromagnetic fields on articular hya- line cartilage: review of experimental and clinical studies. Biomed Pharmacother 2005; 59(7): 388-394.

Tetteh ES, Bajaj S, Ghodadra NS, Cole BJ. The basic sci- ence and surgical treatment options for articular cartilage injuries of the knee. J Orthop Sports Phys Ther 2012; 42(3): 243-253.

Bosetti M, Borrone A, Follenzi A, Messaggio F, Tremolada C, Cannas M. Human lipoaspirate as autologous injectable active scaffold for one-step repair of cartilage defects. Cell Transplant 2015; Epub ahead of print.

 

 

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7 mesi ago News , Servizi

Synetica Evolution: The body Countouring Systems

WHY THE SYNETICA EVOLUTION TECHNOLOGY CAN BE CONSIDERED THE PAINLESS AND REVOLUTIONARY FUTURE OF LIPOSUCTION?

The origin of liposuction can be traced back to an adverse event which occurred in 1921 by Dujarrier when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation due to secondary damage of the femoral artery. 

In the past decades, although the development of the techniques and apparatus, the incidence of complications especially seroma and skin necrosis remained high. Today the liposuction surgery has become one of the most popular cosmetic procedures in the world.

According to the American Society of Plastic Surgery, lipo was the second nationwide trend in the last years (the first was the breast augmentation). There is no upper age limit for patients.This positive outcome has been reached thanks to brand new safe and effective technologies for liposuction.

Synetica Evolution designed by the Italian Company Triworks had the purpose of cutting off the limits and risks of the traditional research on liposuction. But what were these risks?
Several years ago, Lipo was a delicate procedure, performed under regional or general anesthesia with many contradictions and after-effects. Moreover, the recovery was long and the post-hospitalization period required months of additional suffering and endurance.

Needless to say, that the entire procedure hurt and involved pain to a great extent, as the pain medications, the compression garment and after-stress for the patient. In addition, a person’s response to the surgery was varied and each patient healed differently.

Currently, all of these techniques and pains appear to be an obsolete and sore memory.
The typical time frame of a body-contouring session performed with Synetica Evolution is one day and patiens usually get back to work after 2 days liposuction. There is no recovery since the Synetica Evolution requires only a 30 min outpatient surgery.

Because the traditional lipo removes fat but does not tighten skin, only very young patients with good skin elasticity tend to experience the most aesthetically pleasing results. And what about adults? The answer is given by Synetica Evolution which has been created to optimize outcomes enhancing the invasive technique of the traditional lipo surgery. This revolutionary outcome has been reached by combining the ultrasound cavitation and radiofrequency in the same handpiece, and in the same time.

In a certain sense, the development of Synetica Evolution has led the history of Aesthetic Medicine Science to a more effective and evolving goal. The advantage is double inasmuch the method used is doubled: the ultrasound cavitation energy to destroy the adipose tissues and the radiofrequency energy to tighten and restore the skin and damaged tissues from deep inside. The ultrasound energy released by the tip of the cannula permits to lift giving much more elasticity and smoothness to the new epidermis and the treated area

The mixture of two cosmetic techniques in a single cannula (the external part of the handpiece) is a revolution in the traditional way of doing lipo all over the world. Ultrasound cavitation and radiofrequency can be used during the treatments simultaneously or separated according to the surgeon’s needs. Furthermore, the use of two techniques gives no downtime and additional stress for patients. 

The evolution has also reached the instrumentations leading to a new conceptual philosophy in the design of the cannulas used for lipo. Initially, large cannulas were employed, some even up to 1cm in diameter, Synetica has 3 different thin diameter (2-3 mm) capable of penetrating in areas that are normally the most difficult to reach, e.g. chin. It is a smart and minimally-invasive concept of performing liposuction.

Synetica Evolution is particularly designed to re-shape and tighten the body, as well as the face, but also for common disorders of the endocrine system, such as the gynecomastia (the condition of a disproportionate growth of the male breast tissue).

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