Orthobiologics refers to the use of biologic substances used by orthopedic surgeons to improve the healing process. Patients with broken bones and injured ligaments, muscles and tendons may benefit from this less invasive treatment as an alternative to surgery.
Orthobiologics is a part of regenerative medicine, a field that utilizes cells to stimulate the body’s own repair mechanisms to repair or regrow damaged tissues. In orthobiologics, platelet rich plasma and therapeutic cells are made from substances naturally found in your body. Cells from a patient’s bone or an area on their body with more fat (adipose tissue) are rich in regenerative cells, including stem cells.
Using plasma and therapeutic cells may decrease the need for pain medication, help injuries heal more quickly and improve recovery. Let’s look at the ways orthobiologics are used by orthopedic surgeons to help broken bones heal.
Types of orthobiologics
Orthobiologics are products that come from our own bodies used to help the body heal, like platelet-rich plasma (PRP) and stem cells.
Platelet-rich plasma (PRP)
Platelet-rich plasma (PRP) delivers high concentrations of growth factors to damaged or diseased areas to stimulate the healing process. Growth factors are various proteins necessary for cells to work during the healing process. They have an important role in the process of tendon healing, ligament repair, cartilage regeneration and bone formation.
Genetic engineering can produce higher concentrations of this substance, which are naturally found inside bones and other parts of your body in low concentrations. PRP is created by concentrating the growth factors in a small amount of your blood, then using it to help with bone healing.
PRP does not regrow tissue or cartilage. Instead, it draws stem cells to the injured site through a process called chemoattraction. The stem cells are then able to become repair cells.
Stem cells hold the greatest potential for healing because they can turn into muscle, bone, or cartilage. Mesenchymal stem cells are immature cells that are influenced by their surroundings, and have the capacity to differentiate into multiple types of cells. When brought to an injury site, either through chemoattraction or an injection, a stem cell can develop into the kind of cell needed to help in healing.
The most important source of stem cells is bone marrow, and the iliac crest at the top of the pelvis contains the highest concentration of stem cells. This is why it is a common source for harvesting stem cells. Bone marrow is aspirated with a needle, and the aspirate is concentrated to increase the number of stem cells.
As such, it becomes an orthobiologic product called Bone Marrow Aspirate Concentrate (BMAC) that can be inserted into the injury site to promote faster healing.
Applications of orthobiologics
Today, athletes play in increasingly competitive environments, and athletes of every professional level wish to extend the longevity of their career. There is a greater demand on the orthopedic community to provide readily available, quick and effective therapeutic approaches.
Regenerative medicine should not be considered a cure or substitute for surgery, but as protocols for treatment are refined, doctors are reporting more consistently positive results. Orthobiologics, especially PRP, hold a lot of promise as an upcoming and novel treatment option.
Conditions that often benefit from orthobiologics include:
- joint pain or arthritis (such as in the hip or knee)
- tendinitis (in areas such as the hamstring, Achilles tendon and the elbow)
While orthobiologics may not replace standard-of-care orthopedic surgery, orthobiologics can fill a treatment gap for patients who aren’t good candidates for surgery and haven’t responded to physical therapy or steroid injections.
When used in combination with activity modification, immobilization and physical therapy, patients may see pain relief and improvement in function for a year or longer. For those treating arthritis symptoms, PRP is generally repeated yearly. Younger patients with tendinopathies may even be fully rehabilitated with the use of PRP.
Bruising and post-injection discomfort after PRP is a common but temporary side effect. BMAC is a more invasive procedure and, although it is safe when performed by a skilled physician, comes with the risks typical of a surgical intervention. Anytime the invasiveness is increased, the risk to the patient also increases.
The first step in learning more about how orthobiologics may help your condition is to speak with a reputable, trained orthopedic specialist.