Cartilage is known to be damaged by Interleukin-1B (IL-1B), a cell signaling protein responsible for blood-induced cartilage damage. When there is trauma to a joint and a hematoma ensues, the faster the hematoma is evacuated, the less damage to cartilage long term. The blood in the joint now provides an explanation as to why some years after an injury, a patient will present with an osteoarthritic joint. An example is the tear of the Anterior Cruciate Ligament. Findings in the research laboratory also indicate that the faster the blood is removed from the injured joint, the less damage to the cartilage. To emphasize the harm from IL-B1, we are experiencing increased number of patients with a history of an ACL tear who are in need of intervention for post traumatic arthritis at younger ages than in the past even when the ACL has been successfully repaired.

Turning our attention to fractures within the joint, it is important for orthopedic surgeons to realize the impact of blood on cartilage. There is an upregulation of cartilage-degrading enzymes suggesting that the indications for surgical repair of an intra-articular fracture should be expanded and the surgery considered urgent and not delayed. There is an additional adjunct that should be introduced into the algorithm of care of the joint injury and resulting hematoma; namely, Bone Marrow Aspirate Concentrate. Interleukin-1B Receptor Antagonist Protein serves as a dose- and time-dependent protection from blood-induced damage. The higher the concentration and the earlier the introduction, the less cartilage damage sustained. When Bone Marrow is aspirated, recovered with the Mesenchymal Stem Cells (MSCs) are those cells in the bone marrow that produce Interleukin-1 Receptor Antagonist Proteins (IRAP). When the aspirate is concentrated, included in the centrifugate along with the MSCs is a therapeutic quantity of IRAP and that means stopping the degradation of cartilage by the harmful blood born Il-1B.

So what is my take home message? The swollen joint after trauma needs to be aspirated as quickly as possible to remove blood. The intra-articular injury to a joint must be addressed either by surgery or non-operative means on an urgent basis; intervention should not be considered elective. Bone Marrow Aspirate Concentrate should be increasingly used as an adjunct in the care of a joint injury. Should you experience that joint injury, discuss using Bone Marrow Aspirate Concentrate as an adjunct. If your orthopedic surgeon is unfamiliar, once the damage is acutely addressed, call us to see if there is a place for Cellular Orthopedics as a means of improving your long term outcome.

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