• INTRODUCTION
    • Placental and amniotic membrane-based tissues have gained widespread popularity for their ability to promote healing and tissue regeneration and have manifested multiple applications in wound care, burn treatment, and management of various ocular conditions. Recently, there have been multiple studies that investigated the nonoperative uses of placental tissue-based products in orthopaedic sports injuries. However, there is a relative paucity of studies that have attempted to evaluate their adjuvant operative uses. Therefore, the aim of this review was to evaluate the use of placental and amniotic tissue-based products as an adjuvant treatment to the operative management of orthopaedic sports injuries.
  • MATERIALS AND METHODS
    • A comprehensive literature search was performed on PubMed, EBSCO Host, EMBASE, and SCOPUS. Studies published between January 1, 2000 and June 1, 2018 were reviewed. Inclusion criteria were that studies should have reported on: 1) operative uses of placental tissue matrix therapy in tendons and ligaments injuries; and 2) clinical outcomes; in 3) human subjects. In addition, the following studies were excluded: 1) animal studies; 2) basic science studies; 3) non-English language studies; 4) review studies; and 5) duplicate studies across databases. Additionally, to determine the various product compositions and indications for use, we searched publicly available manufacturer's website content, marketing literature, FDA registration documents, and Center for Medicare and Medicaid Services submissions to assess the key differences for each of the products.
  • RESULTS
    • Current evidence has led to investigation of various placental and amniotic membrane products used as an adjuvant treatment to surgical reconstruction of various types of tendon injuries, with a demonstrated effectiveness found mostly in the short-term, with follow up ranging between five weeks and two years. In addition, their safety and minimal complication profile have been demonstrated. Marked differences exist among the currently available products due to variations in their formulations, tissue source, processing methodology, sterilization method, preservation and storage methods, indications for use, and FDA regulation.
  • CONCLUSION
    • Operative uses of placental and amniotic membrane-derived tissues appear to be safe when utilized as an adjuvant or augmentation option along with surgical reconstruction. However, several factors may come into play when considering the diversity of commercially available products. Future clinical trials will need to confirm the safety and demonstrate clearer indications and specific guidelines for use in each clinical scenario involving operative management of tendon injuries. Nevertheless, this review will serve as an up-to-date reference and provide an impetus for future investigations.