We use Zimmer Biomet® Amnioflo®. (Zimmer Biomet® MiMedX® PURION processed dehydrated Human Amnion/Chorion Membrane dHACM)
Amniotic and chorionic products have been used successfully for over a century in the setting of problematic tissue healing and have enjoyed a stellar safety record. Following recent clinical success with treating orthopedic injuries, there has been renewed interest in the use of allograft tissue treatments for musculoskeletal disease and injury. Scientific investigations have concluded that there may be a significant clinical role for amniotic fluid in the setting of osteoarthritis pain. A study presented in 2015 at the American Academy of Pain Medicine Meeting concluded that “Amniotic fluid may be a safe and effective alternative to hyaluronic acid (HA) for osteoarthritis pain.”
Amnionic fluid has demonstrated functional improvement that is greater at 13 weeks than at 30 days; thus it appears to offer longer-lasting relief at a higher level [than hyaluronic acid]. It has also demonstrated a much lower incidence of pain, swelling or inflammation compared to other injections.
Hyaluronic acid injections, like the most recently direct to consumer marketed ‘Gel-One®’ (Zimmer Biomet®, Warsaw, Indiana) include a naturally occurring substance found in the synovial fluid, which lubricates the cartilage and reduces friction in the joint. Studies have demonstrated that at best, the effects of HA usually decline after 7 weeks for a single injection and 12 weeks with multiple injections. Amnionic fluid, which is similar to synovial fluid in its ability to protect and lubricate, also provides cushioning for the knee much the same way as it cushions the fetus. HA treatments are only FDA cleared for use in the knee, while the amniotic injections are cleared for safety and can be used in any synovial joint.
Amnioflo® contains 226 known regulators of healing and inflammation. Once re-hydrated, this medium of beneficial molecules can enhance the tissue healing environment by stimulating proliferation of progenitor cells. These biologic facilitators help encourage tissue growth and healing. Components of the extracellular matrices can incorporate into natural scaffolds that may accelerate healing while limiting scar formation.
Amniotic fluid contains multiple excellent properties for promoting tissue regeneration and repair: The fluid contains growth factors which can help promote new tissue growth and also help to call in the body’s stem cells. Amniotic fluid contains important anti-inflammatory properties from biochemicals called cytokines that help relieve pain. Amniotic fluid is heavily concentrated in important healing molecules, growth factors, hyaluronic acid, antimicrobial components and stem cell activators that are able to work in a anyone’s body without producing an immunologic rejection response, often making it an ideal biologic treatment option either alone or used with other biologic treatment modalities.