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Background. The ankle joint is a frequent site of injury and bone remodeling, and often requires cartilage repair. Studies have shown that growth factors and bioactive compounds have regenerative properties capable of promoting cartilage restoration. Hyaluronic acid (HA) and orthobiologics like platelet-rich plasma (PRP) and adult stem cells (ASCs) are particularly interesting as therapeutic solutions for ankle cartilage repair and have received considerable attention over the years. Methods. We performed a literature review to summarize the clinical uses and outcomes of HA, PRP and ASCs as reparative interventions in osteochondral lesions (OCL) and osteoarthritis (OA) of the ankle, when used alone and post-surgically. Results. In total, 50 studies were eligible and included in this review. HA was shown to be a safe treatment option with a low rate of adverse effects and overall clinical improvement for talar OCL when used alone and post-surgically. PRP was found to be superior to HA for talar OCL in non-surgical and post-surgical patients. Studies evaluating HA injections for ankle OA noted a general improvement in pain and function post-injection with minimal adverse reactions, though there is mixed data regarding the efficacy of PRP injections for ankle OA. High-level randomized controlled trials are lacking for the evaluation of ASCs in talar OCL and ankle OA, though limited research has found them to be safe and efficacious. Conclusions. HA and orthobiologics can be considered for use as a pre-surgical treatment in ankle OCL and OA, or as a second-line treatment for patients who remain symptomatic after surgery. The safety profile and subjective improvement in clinical outcomes following orthobiologic treatments is promising, though requires additional investigation. [ABSTRACT FROM AUTHOR]

Background. This study aimed to evaluate the safety and clinical outcomes of patients treated with micro-fragmented adipose tissue for shoulder pain secondary to glenohumeral osteoarthritis and rotator cuff pathology. Methods. 16 patients (18 shoulders) who had failed previous conservative therapies and received a single injection of micro-fragmented adipose tissue for shoulder pathology. Outcomes including pain, disability, and safety were assessed at minimum of six months. Results. Significant improvements in visual analog scale scores (p < 0.001) and pain disability index scores (p = 0.02) with no major adverse events were observed at six months. Conclusions. Micro-fragmented adipose tissue may be helpful to improve pain and function in a subset of patients with chronic glenohumeral osteoarthritis and rotator cuff tears. No major complications were identified in our case series. [ABSTRACT FROM AUTHOR]