Abstract
The use of intra-articular therapies as sources of growth factors, anti-inflammatory
mediators, and medicinal signaling cells for osteoarthritis (OA) is rapidly evolving.
Amnion, chorion, amniotic fluid, and the umbilical cord are distinct placental tissues
that have been investigated for use in OA. Amniotic membrane (AM) synthesizes a variety
of growth factors, cytokines, and vasoactive peptides that modulate inflammation.
In addition, they contain amniotic epithelial cells and amniotic mononuclear undifferentiated
stromal cells, which have chondrogenic and osteogenic differentiation capacity. AMs
are also rich sources of hyaluronic acid and proteoglycans, which could play a role
in the potential therapeutic relief of OA. Currently, there are several commercially
available formulations of AM that differ based on content as well as how they were
preserved. Understanding the processing of amniotic tissue is important because of
their distinct mechanical and biologic effects of preservation on AM grafts. To date,
there have been two preclinical and only one clinical study on the use of AM for OA,
which show promising results. Many high level of evidence clinical trials are currently
underway investigating the use of AM of OA. Future basic science and clinical research
is warranted to better understand the anti-inflammatory and chondroregenerative properties
of amniotic tissue and to determine clinically what amniotic tissue product is most
efficacious for symptomatic OA.
Keywords
cartilage - osteoarthritis - amniotic suspension allograft - amniotic membrane - amniotic
fluid
