Hannah Bradsell

Bio: Hannah Bradsell is an academic researcher from University of Colorado Denver. The author has contributed to research in topics: Medicine & Physical therapy. The author has an hindex of 2, co-authored 9 publications receiving 4 citations.

The essential roles of human adipose tissue: Metabolic, thermoregulatory, cellular, and paracrine effects

Abstract: Introduction Over the past decade, human adipose-derived mesenchymal stem/signaling/stromal cell (ADSC) therapies have become increasingly popular as a biologic treatment for a variety of orthopedic conditions. ADSCs represent a source of stromal cells with biologic properties that allow for paracrine and immunomodulatory functions and the ability to differentiate into various downstream cellular tissues. Before considering the use of adipose tissue as a cellular source, it is imperative to understand its anatomy and physiology and its roles in the human body. Objectives To review the current literature regarding the anatomy, physiology, and various roles of human adipose tissue, as well as harvesting techniques and its role in biologic therapy. Methods A comprehensive literature review that included searches of PubMed, medline, EMBASE, and Google Scholar database(s), including both preclinical and clinical studies, was performed. Results This manuscript represents an updated understanding of adipose tissue, including its anatomy, functions in the human body, and role as a perivascular cellular source for tissue renewal, in addition to its role in providing cushioning and support to various structures. Conclusion Adipose tissue is widespread throughout the body and serves multiple physiologic functions. It can be harvested through several techniques and is an abundant source of bioactive molecules and ADSCs. Research in orthopedic surgery has begun using adipose tissue as a source of homologous and non-homologous cell and tissue applications. Future study will continue to investigate optimal sources of adipose-derived cells and tissues, and its therapeutic applications in orthopedics.

A review of bone marrow lesions in the arthritic knee and description of a technique for treatment

Abstract: Introduction Subchondral bone pathology includes a wide range of pathologies, such as osteoarthritis, spontaneous insufficiency fractures, osteonecrosis, transient bone marrow lesions syndromes, and trauma. They show typical magnetic resonance imaging (MRI) findings termed bone marrow lesions (BMLs). However, the etiology and evolution of BMLs in multiple conditions remains unclear. There is still no gold standard treatment protocol in treating BMLs in the knee, and a variety of treatment modalities have been tested in the hope that they might reduce pain and stop disease progression. Objectives To review the treatment options for BMLs of the knee. Methods A literature review was performed that included searches of PubMed, Cochrane, and Medline databases using the following keywords: Bone marrow lesions, sub chondroplasty, bone marrow concentrate, platelet-rich plasma (PRP), subchondral bone augmentation. Results The use of novel biologic techniques to treat BMLs in the knee, such as PRP and Bone Marrow Cells, has yielded promising clinical outcomes. Conclusions Future research of BMLs will be mandatory to address the different pathologies better and determining appropriate treatment strategies. There is still a need for high-quality RCTs studies and systematic reviews in the future to enhance further treatment strategy in preventing or treating BMLs of the knee.

Sex-Based Differences in Adult ACL Reconstruction Outcomes

Abstract: In the setting of ever improving outcomes following anterior cruciate ligament (ACL) reconstruction, both objectively and subjectively, there remains continued interest in better understanding the differences in outcomes between male and female patients. The current review investigates the recent literature surrounding the roles of biological sex in adult ACL reconstruction outcomes. Within the past five years, the most prominent and recurrent difference between male and female patient cohorts is the subjective report of pain and function. Female patients have been consistently shown to have worse self-reported outcomes following ACL reconstruction. Specific and quantifiable subjective outcomes that are highlighted include the International Knee Documentation Committee (IKDC) subjective score, the Knee injury and Osteoarthritis Outcome Score (KOOS), and patient-acceptable symptom state (PASS). Current research on the topic of biological sex–based differences in ACL reconstruction outcomes can be divided into four main categories: patient-reported subjective outcomes; physical assessment and gait analysis; kinematics; and rates of reinjury, revision, and contralateral reconstruction. This chapter provides a summary of recent literature focused on these four main areas of interest related to ACL reconstruction outcomes in males and females.

Epidemiology of Female Versus Male Athletic Injuries

Abstract: Several epidemiologic studies have consistently reported higher rates of severe injuries, injuries requiring surgery, and greater time loss from participation due to injury among female athletes compared with male athletes. Concussion incidences have been found to be the highest in football, but in gender-comparable sports, females have higher rates than males, which has also appeared to be related to increased risk of musculoskeletal injury. Shoulder instability is more frequently reported in male athletes, but females are underrepresented in studies regarding this injury and it is important to understand that shoulder laxity and instability are not synonymous. Lower extremity injury rates are considerably higher in female athletes, particularly injuries related to the ankle and knee. Anatomic and biomechanical gender differences in the anterior cruciate ligament have been heavily explored in an attempt to provide explanations for the significantly higher injury rates seen in female athletes. The prevalence of developing an overuse injury in female athletes can be attributed to the high risks associated with the female athlete triad—a combination of low energy availability, menstrual dysfunction, and low bone mineral density.

Mesenchymal stem cells for subchondral bone marrow lesions: From bench to bedside

Abstract: Subchondral bone marrow lesions (BMLs) are areas of disease within subchondral bone that appear as T1 hypointense and T2 hyperintense ill-defined areas of bone marrow on magnetic resonance imaging. The most common bone marrow lesions include subchondral lesions related to osteoarthritis, osteochondral defects, and avascular necrosis. Emerging therapies include autologous biologic therapeutics, in particular mesenchymal stem cells (MSCs), to maintain and improve cartilage health; MSCs have become a potential treatment option for BMLs given the unmet need for disease modification. Active areas in the preclinical research of bone marrow lesions include the paracrine function of MSCs in pathways of angiogenesis and inflammation, and the use of bioactive scaffolds to optimize the environment for implanted MSCs by facilitating chondrogenesis and higher bone volumes. A review of the clinical data demonstrates improvements in pain and functional outcomes when patients with knee osteoarthritis were treated with MSCs, suggesting that BM-MSCs can be a safe and effective treatment for patients with painful knee osteoarthritis with or without bone marrow lesions. Preliminary data examining MSCs in osteochondral defects suggest they can be beneficial as a subchondral injection alone, or as a surgical augmentation. In patients with hip avascular necrosis, those with earlier stage disease have improved outcomes when core decompression is augmented with MSCs, whereas patients in later stages post-collapse have equivalent outcomes with or without MSC treatment. While the evidence for the use of MSCs in conditions with associated bone marrow lesions seems promising, there remains a need for continued investigation into this treatment as a viable treatment option.

A Marked Low-Grade Inflammation and a Significant Deterioration in Metabolic Status in First-Episode Schizophrenia: A Five-Year Follow-Up Study

Abstract: The objective of this study was to evaluate how schizophrenia spectrum disorders and applied long-term (5.1 years) antipsychotic (AP) treatment affect the serum level of acylcarnitines (ACs), cytokines and metabolic biomarkers and to characterize the dynamics of inflammatory and metabolic changes in the early course of the disorder. A total of 112 adults participated in the study (54 patients with first-episode psychosis (FEP) and 58 control subjects). Biomolecule profiles were measured at the onset of first-episode psychosis and 0.6 years and 5.1 years after the initiation of APs. The results of the present study confirmed that specific metabolic–inflammatory imbalance characterizes AP-naïve patients. Short-term (0.6-years) AP treatment has a favourable effect on psychotic symptoms, as well as the recovery of metabolic flexibility and resolution of low-level inflammation. However, 5.1 years of AP treatment resulted in weight gain and increased serum levels of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon-γ, hexoses, acetylcarnitine, short-chain ACs (C3, C4) and long-chain ACs (C16:2, C18:1, C18:2). In conclusion, despite the improvement in psychotic symptoms, 5.1 years of AP treatment was accompanied by a pronounced metabolic–inflammatory imbalance, which was confirmed by the presence of enhanced pro-inflammatory activity and increased obesity with changes in the metabolism of carbohydrates, lipids, and their metabolites.

Minimally invasive cell-based therapy for symptomatic bone marrow lesions of the knee: A prospective clinical study at 1 year.

Abstract: Bone Marrow Lesions (BMLs) are typical findings in magnetic resonance imaging (MRI) present in different pathologies, such as spontaneous insufficiency fractures, osteonecrosis, transient BML syndromes, osteoarthritis, and trauma. The etiology and evolution of BMLs in multiple conditions remain unclear. There is still no gold standard protocol for the treatment of symptomatic BMLs in the knee. The biologic augmentation by Osteo Core Plasty is a new treatment modality showing promising results reducing pain with the aim to stop the progression of the disease. The purpose of this prospective study is to report the clinical outcomes and safety of Osteo Core Plasty for the treatment of symptomatic BMLs in the knee. Fifteen patients with symptomatic BMLs of the knee treated with the Osteo Core Plasty technique were included and followed prospectively for a minimum of 12 months. Each patient was evaluated before the surgery and respectively at 6 and 12 months using the Tegner Score, Marx Score, the International Knee Documentation Committee (IKDC), the Knee Injury and Osteoarthritis Outcome Score (KOOS) divided in pain, activity daily living (ADL) and Quality of Life (QOL) subscale and the Visual Analogue Scale (VAS) for pain. All clinical scores except Tegner and Marx score showed an overall statistically significant improvement through the entire follow-up (p<0.05) and a significant improvement (p<0.05) between each follow-up period (T0 versus T1; T0 versus T2; T1 versus T2). No complications were reported. These preliminary results confirm that biological subchondral bone augmentation by Osteo Core Plasty technique is a safe and effective minimally invasive treatment option for symptomatic BMLs in the knee at 1-year follow-up. There is still a need for high-quality RCTs studies and systematic reviews in the future to enhance further treatment strategies in preventing or treating BMLs of the knee.

Regenerative Translation of Human Blood-Vessel-Derived MSC Precursors

Abstract: Mesenchymal stem/stromal cells (MSCs) represent a promising adult progenitor cell source for tissue repair and regeneration. Their mysterious identity in situ has gradually been unveiled by the accumulating evidence indicating an association between adult multipotent stem/progenitor cells and vascular/perivascular niches. Using immunohistochemistry and fluorescence-activated cell sorting, we and other groups have prospectively identified and purified subpopulations of multipotent precursor cells associated with the blood vessels within multiple human organs. The three precursor subsets, myogenic endothelial cells (MECs), pericytes (PCs), and adventitial cells (ACs), are located, respectively, in the three structural tiers of typical blood vessels: intima, media, and adventitia. MECs, PCs, and ACs have been extensively characterized in prior studies and are currently under investigation for their therapeutic potentials in preclinical animal models. In this review, we will briefly discuss the identification, isolation, and characterization of these human blood-vessel-derived stem cells (hBVSCs) and summarize the current status of regenerative applications of hBVSC subsets.