Orthobiologics is a relatively new area of study that has captured the interest of orthopaedic surgeons in their effort to find ways to facilitate the body's healing process. Orthobiologics is a dynamic scientific field with new developments and discoveries attracting ongoing interest. Orthobiologics involves scientific interventions and treatments which use the body's own growth factors and proteins to help muscles, tissues, ligaments, tendons and bones heal more quickly.
There are several different orthobiological treatments currently used by orthopaedic surgeons. Three orthobiological treatments used to treat knee osteoarthritis include:
- Platelet Rich Plasma (PRP),
- Autologous Cartilage Implantation, and
- Bone Marrow Simulation
What is Platelet Rich Plasma (PRP)?
Platelet rich plasma (PRP) is blood plasma that is enriched with additional platelets. Platelets release proteins called growth factors which speed up tissue regeneration, repair and healing. Growth factors are important in part because they facilitate a process called "chemoattraction" which draws stem cells to the location of the injury. PRP production involves several different steps.
- Blood is drawn from the patient peripherally.
- The blood is placed in the centrifuge to separate the plasma from the platelets.
- This is injected into the injury site.
PRP is currently used in a variety of orthopaedic medical treatments including osteoarthritis, plantar fasciitis and tendinitis. A recent article published by the American Journal of Sports Medicine stated that PRP decreases NFkB which is a major enzyme in the pathway of the formation of osteoarthritis.
What is Autologous Cartilage Implantation?
When the articular cartilage is damaged in the knee, exposed nerve endings can cause significant pain and eventually lead to osteoarthritis. Autologous cartilage implantation is a type of transplantation that takes either donor articular cartilage cells or the patient's own cartilage. Cultured autologous cartilage cells are used in order to promote growth in cartilage damage and repair the cartilage.
For the treatment of osteoarthritis in the knee, the cartilage is transplanted in the arthritic area of the knee. A recent article in the Journal of Bone and Joint Surgery noted that long term follow up data of 7 to 10 years suggests good to excellent results.
What is Bone Marrow Stimulation?
Bone marrow stimulation is an orthopaedic surgical technique used to help repair cartilage in the knee. Bone marrow stimulation is a treatment for cartilage injuries and degenerative problems in the knee.
Bone marrow stimulation is a surgical procedure where multiple drill holes are placed into the area of arthritis in the knee. The body's own stem cells invade that region producing fibrocartilage which is a scar tissue like cartilage. This type of transplantation has decreased results over time whereas the autologous transplantation has better longevity.
Orthobiologics Offer Promising Future
Orthobiological treatments offer a promising future to an orthopaedic surgeon who treats degenerative conditions like osteoarthritis of the knee and osteoporosis. Further research and new treatments are currently being explored and new advancements in orthobiologics are continually introduced. One of the latest innovations includes liquid allografts or so called bone glues that mend bone fractures while supporting the healing process.
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