Orthobiologics is a relatively recent form of regenerative medicine that harnesses the body’s power to heal itself. Orthobiologics, also known as PRP and stem cell therapy, are considered naturally occurring cells and growth factors which are concentrated and re-introduced into a target area such as joints, ligaments, or tendons.
Using guided ultrasound imaging, orthobiologic injections are a nonsurgical, noninvasive treatment for a variety of orthopedic conditions such as osteoarthritis, rotator cuff tear, tendinopathy and even “bone spurs”. Regenerative injections can be used to reduce joint pain and inflammation, boost musculoskeletal function, and stimulate healing or tissue regeneration.
Orthobiologic compounds fall into two categories – autologous and allogeneic. Autologous orthobiologics are used to treat the same patients from which they are drawn while allogeneic orthobiologics are derived from someone other than the patient.
Some forms of autologous orthobiologics include the following:
PRP, or platelet rich plasma, is an orthobiologic in which blood is drawn from a patient and processed to concentrate platelets. When injected into an area where there is tissue damage, platelets aggregate and initiate ”chemotaxis”, which is a healing response produced by a cascade of growth factors signaled to the area.
Bone Marrow Aspiration Concentrate (BMAC)
BMAC is derived from the patient’s own bone marrow. Once processed, BMAC is rich in mesenchymal stem cells, platelets, and growth factors which aid in healing and therefore, reduce inflammation. Many older patients are concerned that they may not have enough stem cells in their bone marrow. While they may have fewer cells, they still have additional cells in the marrow that aid in the healing response.
Adipose tissue or fat cells have an abundance of stem cells, and thus, healing properties. Adipose tissue is drawn from a patient, processed into a concentrate, and re-introduced into a targeted treatment area.
Allogeneic biologics are derived from a source other than the patient treated including the following:
Hyaluronic gel is sometimes referred to as an allogeneic orthobiologic. As some insurance companies cover hyaluronic injections for knee pain, their use has become very popular. The gel acts as an anti-inflammatory and provides some cushion to the joints.
Other Allogeneic Biologics
Additional allogeneic orthobiologics that have become popular recently include amniotic tissue, umbilical cord stem cells, and exosomes. Recently, the FDA has halted the distribution of these substances until the manufacturers complete appropriate applications.
Look for more information on allogeneic orthobiologics in future blog posts.