Orthobiologics

Platelet-rich plasma (PRP) therapy is increasingly used to treat injuries in ligaments, tendons and cartilage. Additionally, it is proving effective in addressing osteoarthritis in various joints like the hip, knee and shoulder.

What happens during PRP therapy?

During PRP therapy, the patient’s blood is drawn and spun in a centrifuge, a process that separates the various components of the blood. This isolates the platelets, a solid component in the blood, from other blood cells. The platelet-rich solution is then injected into the area of the body that needs to be treated. This is usually done with the guidance of an ultrasound device or X-ray.

At this time, insurance does not provide coverage for PRP therapy; it is a self-pay procedure.

Benefits of PRP therapy

Platelets found in the patient’s own blood contain growth factors that stimulate the body’s natural healing process, aiding in the repair of injured tendons or cartilage while also lessening inflammation. This can lead to decreased joint fluid inflammation, reducing pain and improving overall function.

PRP therapy supports tissue reorganization (or remodeling) and offers an effective solution for those who haven’t found significant relief through traditional treatments.

PRP therapy can help patients with chronic orthopaedic conditions or injuries avoid or postpone surgery. This can be beneficial for athletes who want to avoid a potentially career-ending or career-altering surgery.

Adipose-derived cell therapy uses fat collected from your body (lipoaspirate), which contains a high concentration of important cells called mesenchymal stromal cells (MSC) alongside various growth factors. Under certain conditions, these cells have the potential to generate new tissue like bone, cartilage, fat and blood vessels.

Fat can be collected from numerous areas of the body through a procedure similar to liposuction.

How is lipoaspirate obtained?

Lipoaspirate is collected from your body through a minimally invasive procedure (involving a small puncture in the skin). The collected fat is then delicately processed and purified. The procedure is typically done under local anesthesia, either with or without light sedation, and may take place in the operating room.

What are the risks associated with obtaining lipoaspirate?

Risks are rare, but may include:

• Bleeding
• Bruising at fat harvesting site
• Infection
• Accidental puncture of the inner abdominal wall, potentially requiring surgical repair
• Persistent pain after the procedure

How is lipoaspirate used to help repair or heal tissue?

Experts are still determining how lipoaspirate works within the body (mechanism of action), as well as how well it works (clinical efficacy). Nonetheless, experts do believe that injecting live mesenchymal stem cells (MSCs) and growth factors into affected joints or other areas in the body promotes pain reduction and enhanced function. Numerous studies have verified the safety of this procedure.

Bone marrow concentrate (BMC), also known as bone marrow aspirate concentrate (BMAC), is a fluid containing cells taken from bone marrow, including mesenchymal stem cells (MSCs). Bone marrow is the soft, spongy substance that fills the inner cavities of bones. It is where blood is produced.

Tiny spaces in the bone marrow hold blood and stem cells, the primitive cells that are able to grow into various types of blood cells. Under certain conditions, some of these cells can also create new tissue like bone, cartilage, fat and blood vessels.

How is BMC obtained?

The first step in producing BMC is to collect bone marrow aspirate through a minimally invasive method that uses a needle to remove bone marrow from a large bone, such as the pelvic bone. The procedure is generally done under local anesthesia, with or without light sedation, or in the operating room. The aspirate is then put through processing that uses a centrifuge.

Bone marrow processing methods vary widely and can affect the number and quality of cells.

What are the risks involved with obtaining bone marrow concentrate?

Risks are rare, but may include:

• Bleeding
• Infection
• Pain that continues after the procedure

How is BMC used to help repair or heal tissue?

Bone marrow aspirate indications can serve as a surgical aid to promote healing, particularly for bone and cartilage surfaces. This has been used for cartilage repair, cartilage restoration, joint preservation procedures, core decompression and other surgical procedures. Moreover, this approach can be applied across various joints with arthritis and soft tissue structures.

Experts are still determining how BMC works within the body (mechanism of action), as well as how well it works (clinical efficacy). However, experts do believe that BMC decreases (modulates) inflammation and it can potentially help reduce pain, improve function and help new tissue form. Numerous studies have verified the safety of this procedure.

Corticosteroid injections, intended for joints and soft tissue, can help relieve pain and inflammation in a specific area. These injections typically contain a corticosteroid medication and a local anesthetic. The number of shots you can get in a year is limited due to potential side effects, including damage to the joint or soft tissue. However, patients generally have found significant, immediate relief.

Viscosupplementation is a medical procedure that involves the injection of a gel-like fluid called hyaluronic acid, most commonly into the knee. Hyaluronic acid is a naturally occurring lubricant that allows for smoother joint movement, potentially reducing pain and inflammation in joints affected by osteoarthritis.

Options include:

• Durolane
• Euflexxa
• Gelsyn
• Gel-one
• Hymovis
• Monovisc
• Orthovisc
• Synvisc
• Synvisc One