A major complication associated with a total hip/knee arthroplasty surgery is insufficient wound healing of soft tissue at the site of incision. This increases the risk of postoperative infections, knee/hip dislocations, loosening of tissue implants and increased pain. Advent of amniotic membrane allografts has significantly reduced these risks due to their ability to enhance wound healing processes. Presented in this article is a brief overview on Amniotic Allografts that are gaining popularity as a clinical tool to help in tissue repair around damaged joints and reduce pain.
What are amniotic membrane allografts?
Amniotic membrane is 0.02-0.05mm thick semi-transparent layer located in the innermost region of a placenta. Each membrane is further divided into 3 layers – inner epithelium, basement membrane and an inner stromal layer.
- Epithelial layer made up of cuboidal-shaped epithelial cells and contains small projections on the outer side called microvilli. The cells are metabolically active, and are responsible for maintaining the consistency of amniotic fluid. Further, epithelial cells produce several growth factors and proteins required for preserving the pluripotency of stem cells.
- Basement layer is made of proteins like collagen, laminin and hyaluronic acid that can accelerate cell division and wound repair.
- Stroma is a spongy layer that is further divided into a region that is rich in cells called fibroblasts and another region does not contain any cells. Stromal layer is required for anchoring epithelial and basement layers.
What are the properties of amniotic membranes?
Amniotic membranes were first used in 1910 for the repair and regeneration of damaged skin by JW Davis. Beneficial properties of amniotic membranes include:
- They contain a high number of multipotent progenitor cells, also known as mesenchymal stem cells. Once injected into a tissue, these stem cells can divide and form into any type of the cell.
- Amniotic membranes lack blood vessels and do not have any blood supply. Due to this, immune cells are completely non-existent in these membranes.
- These membranes secrete growth factors, cytokines and other proteins that reduce inflammation and fibrosis.
- Amniotic membranes produce antimicrobial proteins that act against microbes and prevent infections.
- Research suggests amniotic membrane allografts can regulate immune functions so that the graft is more acceptable by the human body.
How do amniotic membranes heal joint damage?
Amniotic membranes are supplied as vials that are cryopreserved in liquid nitrogen. These vials are injected into the joint tissues (also known as intraarticular injections) in patients suffering with either joint pain or undergoing arthroplasty surgeries. Once injected, amniotic membrane attaches and gets integrated into the joint scaffold. Following this, mesenchymal stem cells fill the joint space and initiate tissue repair by producing new matrix and secreting huge amounts of collagen and other important proteins required for this process. Clinical studies on arthroplasty patients have shown the usability of these amniotic injections in reducing both pain, stiffness and inflammation tremendously. Amniotic injections have also been used successfully in the repair and regeneration of injured tendons without causing any scar formation.
Stem X is one of the very few organizations that are specialized in treating chronic joint pain and tissue damage using amniotic membrane allografts. Please consult a physician at www.stemxgroup.com to know more about the procedure and evaluate its applicability to your condition.