What are biologics?
Orthobiologics are therapies that use biological tissues derived from a patient’s own body to help enhance the patient’s healing process. Orthobiologics harness the healing power of the human body. They are used in surgery to enhance repair, and for nonsurgical treatment to delay or avoid the need for more invasive procedures.
Bone marrow aspirate and platelet-rich plasma (PRP) are two types of orthobiologics that are used in orthopaedic medicine. Bone marrow and PRP stimulate and augment repair of musculoskeletal damage from trauma, sports injuries, and degenerative conditions like osteoarthritis of the knee. The goal is to improve outcomes by promoting healing and tissue repair.
Orthobiologics offer solutions to a number of compelling problems like tendinopathies and degenerative arthritis that have previously been limited to medications, surgery, rehabilitation, and joint replacement. Orthobiologics are especially valuable for young adults and the elderly.
Platelets are best known for their blood clotting ability, but platelets are a natural reservoir of hundreds of biologically active proteins called growth factors. These growth factors play a key role in healing and tissue repair. When there is an injury or inflammation, platelets flood the area to stop bleeding, and heal damaged tissues.
Platelet rich plasma is a solution made by concentrating platelets, and growth factors to increase potency more than 10x greater than normal. PRP harnesses the power of your body’s natural healing abilities to promote healing, and repair tissues.
A small amount of your blood is obtained from a simple blood draw. Your whole blood is centrifuged to separate and concentrate the platelets, growth factors and biological proteins that play an important role in wound healing and stimulate tissue regeneration. Because it is made from your own blood and injected back into your tissues, there is no risk of adverse reaction, or disease transmission.
Bone marrow aspirate is a liquid that is taken from the bone marrow. The bone marrow is the tissue inside of bones where blood cells are made. Bone marrow aspirate contains mesenchymal stem cells, which are cells that can renew themselves and differentiate into bone, cartilage, ligament, and tendon cells which your body uses to maintain, repair, and rebuild tissues.
Mesenchymal stem cell therapy involves aspiration of bone marrow from the pelvic bone using a needle in a minor, minimally invasive procedure. The aspirate is put in a centrifuge and spun to isolate and concentrate the stem cells. This takes about 30-60 minutes.
Then the concentrate is injected into the joint, muscle, or tendon to treat an injury or applied to a damaged tissues during surgery. Dr. Patel uses ultrasound or direct arthroscopy to inject the concentrate. Mesenchymal stem cell therapy treats inflammation and pain and stimulates the growth of new blood cells to improve healing especially in tissues with a poor blood supply like cartilage, tendons, and ligaments. Mesenchymal stem cell therapy is used to treat damage to knee ligaments, the rotator cuff, articular cartilage, and osteoarthritis of the knee.
Orthobiologics can be used to treat a variety of orthopaedic conditions, including conditions for which conventional treatments are lacking. Here are a few of the ways biologics can improve healing and restore function.
Tendon tissue has a poor blood supply and limited healing capacity. Tennis elbow is a common source of pain and disability. Steroid injections are the gold standard to reduce inflammation in the short term. However, platelet rich plasma therapy works to stimulate the healing process and reduce inflammation, restoring function and alleviating pain in the long term. PRP therapy can be used to treat inflammation in the patellar tendon in the knee.
PRP can treat the pain and inflammation of shoulder bursitis.
Clinical results after an isolated meniscus repair are not always satisfactory with a failure rate of around 20-25%. PRP therapy combined with meniscus repair reduced the risk the failure risk.
Biologics are used to promote fracture union in certain subchondral fractures near the joint.
The most common reason for a knee replacement is knee osteoarthritis. Orthobiologics can reduce the pain associated with osteoarthritis and patients may be able to avoid knee replacement surgery. The procedure causes minor, or no discomfort, and patients can return to their daily lives within a few days. Initial improvement will be apparent in the first few weeks and symptoms will steadily improve. Results can last for years.
Orthobiologics can be an effective treatment option for many orthopaedic conditions. If you are considering biologics for your condition, talk to Dr. Patel to see if they are right for you.
Dr. Ronak Patel offers the full spectrum of treatments both surgical and nonsurgical. He believes that many patients can be successfully treated without surgery. He will provide you with a balanced and well-reasoned opinion to help you make an informed decision about your treatment.
Dr. Ronak M. Patel is a double board-certified orthopaedic surgeon and sports medicine physician. He completed his bachelor’s degree, medical degree, and residency training at Northwestern University. He, then completed his fellowship training at the Cleveland Clinic. He specializes in the treatment of complex knee, shoulder and elbow injuries and degenerative conditions. Contact him to schedule a consultation to learn more about how he can help you return to the life you love and the activities that make life worth living. He serves teens and adults in Chicagoland and NW Indiana.
At a Glance
Ronak M. Patel M.D.
- Double Board-Certified, Fellowship-Trained Orthopaedic Surgeon
- Past Team Physician to the Cavaliers (NBA), Browns (NFL) and Guardians (MLB)
- Published over 49 publications and 10 book chapters
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