| Sažetak | Liječenje sportskih ozljeda iznimno je zahtjevno područje u medicinskoj praksi. Njegova kompleksnost proizlazi iz niza čimbenika, među kojima se ističu stvaranje prikladnog programa terapije nakon kojega se oštećeno tkivo mora vratiti u prvobitan oblik ne samo po pitanju strukture, nego i funkcionalnosti, pritisak ljudi iz neposrednog okruženja ozlijeđenog sportaša, poput sponzora, medija, pa i samog sportaša koji se želi vratiti natjecateljskom sportu u najkraćem roku, često ne razmišljajući o posljedicama, te relativna ograničenost po pitanju izbora terapeutskih metoda koje će se primjenjivati u liječenju. Sportska medicina je, kao i medicina u globalu, iznimno napredovala po pitanju prevencije i dijagnostike ozljeda, ali po pitanju terapije već dugo vremena nema većih promjena, te se i danas, kao i prije nekoliko desetljeća, u liječenju primjenjuju praktički isti algoritmi, poput PRICE (Protect, Rest, Ice, Compression, Elevation) protokola u liječenju akutnih ozljeda mekih tkiva, zatim upotrebe klasičnih nesteroidnih antiupalnih lijekova i kortikosteroida, te upotrebe struje, magneta, lasera i ultrazvuka u programu fizikalne rehabilitacije nakon inicijalnog zbrinjavanja ozljede. Iako se ne može poreći određena efikasnost tih metoda, ozljede liječene na taj način često prelaze u kroničan oblik, a zbog manjkavosti prirodnih mehanizama popravka oštećenog tkiva, često dolazi do stvaranja fibroze na mjestu ozljede, a samim time i do povećanog rizika za nastanak recidiva. Iz tog razloga, moderna sportska medicina zahtjeva otkriće i primjenu novih metoda u liječenju ovakve vrste ozljeda. Kako stvari stoje, u bliskoj budućnosti moglo bi doći upravo do takvih promjena. Uvođenjem bioloških tretmana u medicinu, poput primjene autologne kondicionirane plazme ili mezenhimalnih matičnih stanica, moglo bi doći do revolucije u liječenju sportskih ozljeda po pitanju trajanja oporavka, kvalitete i funkcionalnosti tkiva nakon završenog liječenja te čak i prevencije budućih, sličnih ozljeda. Mezenhimalne matične stanice mogu biti izolirane iz niza različitih tkiva u ljudskom tijelu, uključujući koštanu srž, masno tkivo, sinoviju, perifernu krv i perinatalna
tkiva, ali se jednako tako različiti tipovi razlikuju s obzirom na potencijal proliferacije i diferencijacije u druga tkiva. U ovom sustavnom pregledu literature izvršena je evaluacija trenutno dostupnih podataka na temu regenerativne medicine, tkivnog inženjeringa i primjene matičnih stanica u liječenju različitih tkivnih defekata. Kratki zaključak ovog istraživanja je kako uistinu postoje iznimno obećavajući podaci vezani uz upotrebu matičnih stanica u sportskoj medicini, ali i da je potrebno provesti još veliki broj studija na tu temu, kako bi se sa sigurnošću utvrdile sve prednosti i eventualni nedostatci primjene ovakvog tipa liječenja. |
| Sažetak (engleski) | Treatment of sports injuries is an extremely demanding area in medical practice. Its complexity stems from a number of factors among which the creation of an appropriate therapy program stands out, after which the damaged tissue must return to its original shape not only in terms of structure but also functionality, as well as pressure from people in the immediate environment of the injured athlete, such as sponsors, media and even the athlete himself who wants to return to sports as soon as possible, often not thinking about the consequences, and in the end, limitation in the choice of therapeutic methods to be used in treatment. Sports medicine, like medicine in general, has made great progress in terms of prevention and diagnosis of injuries, but at the same time, in terms of therapies, for a long time there have not been any major changes.
Today still, just like a few decades ago, practically the same algorithms are applied in treatment, such as PRICE (Protect, Rest, Ice, Compression, Elevation) protocol in the treatment of acute soft tissue injuries, use of classic nonsteroidal anti-inflammatory drugs and corticosteroids, use of electricity, magnets, lasers, and ultrasound in a physical rehabilitation program after the initial care of the injury. Although the effectiveness of these methods cannot be denied, injuries treated that way often turn into a chronic form, and due to the lack of natural mechanisms for repairing damaged tissues, fibrosis often occurs on the site of the injury, and thus there is an increased risk of recurrence. For this reason, modern sports medicine requires the discovery and application of new methods in the treatment of this type of injuries. As things stand, such changes may occur in the near future. By introducing biological treatments into medical practice, such as platelet-rich plasma or mesenchymal stem cells, it is possible to revolutionize the treatment of sports injuries in terms of seeking recovery, quality and functionality of tissues after treatment and even prevention of future similar injuries. Mesenchymal stem cells can be isolated from a number of different tissues in the human body, including bone marrow, adipose tissue, synovium, peripheral blood and perinatal tissue, but in the same way, different types differ in terms of potential for proliferation and differentiation into other tissues. In this systematic review of literature, the evaluation of currently available data on the subject of regenerative medicine, tissue engineering and stem cell application in the treatment of various tissue defects was performed. The short conclusion of this research is that there truly do exist extremely promising data related to the use of stem cells in sports medicine, but also that a large number of studies regarding that topic yet need to be conducted, to determine with certainty all advantages and potential shortcomings of this type of treatment. |
