What is it?

You’ll often hear orthobiologics referred to as stem-cell therapy, cell-therapy, or regenerative medicine. You may have heard an elite athlete having an injection procedure after a tissue injury. These options are now available to athletes and non-athletes of all ages. These are therapeutic options that are derived by using naturally occurring factors present in your body. This can include cells, tissues, growth factors, and various components of your blood.

Approximately 47 million people in the United States have been diagnosed with arthritis. 4 out of 5 patients with arthritis have movement limitations. In an effort to keep things safe, initial interventions usually consist of engaging in physical therapy, rehabilitation, weight management, use of anti-inflammatories, dietary optimization, bracing, activity modification, and steroid injections. Once these conservative interventions fail, surgery is often presented as an invasive option. Many of these patients are looking for another non-surgical option that has a chance of reducing their pain and improving their lifestyle.

Across a broad range of ages, many people maintain their fitness levels and optimize their health by taking part in recreational or competitive sports. Sometimes they sustain traumatic or overuse injuries that prevent them from taking part in their hobbies. These patients often want a quicker, faster return to function without invasive surgical intervention.

There is also a subset of patients in whom surgical intervention is warranted – such as a young patient with a rotator cuff tear, an ACL rupture, or a meniscal tear. These patients want a chance to speed up and improve the quality of their recovery after surgery.

All of these patients have the potential to benefit from regenerative therapy options.

 

What types of injections are available?

Platelet Rich Plasma (PRP)
Platelet rich plasma (PRP) therapy takes your own blood, concentrates its healing properties, and reinjects it back into you to speed healing and/or reduce inflammation.

  • PRP releases 3-5 times the growth factors compared to normal human blood.
  • PRP is a type of biologic or regenerative medicine and uses the body’s natural healing abilities to either enhance healing after injury/surgery or to reduce inflammation and pain in an injured or arthritic joint.
  • Research shows that platelets found in blood have growth factors that can help injured tissue heal and accelerate healing of damaged tissue and in certain pathologies such as mild osteoarthritis, may be able to reduce inflammation.
  • Recent studies suggest that a specific type of PRP, called Leukocyte Poor PRP (LP-PRP) results in more reliable improvements in pain and function for those with mild to moderate knee arthritis.

Commonly treated conditions include:

  • Shoulder – Rotator cuff injuries, biceps tendonitis, labral and SLAP tears, and mild arthritis
  • Knee – Ligament injuries, meniscus tears, patellar tendonitis, and mild arthritis
  • Hip – Hamstring tears/partial tears, mild hip arthritis
  • Elbow – Tennis elbow and golfer’s elbow

 

Bone Marrow Aspirate Concentrate (BMAC)/Stem Cells
A stem cell is an immature, undeveloped cell found in the bone marrow. Although the research is still ongoing, there is some evidence to suggest that stem cell treatments may help heal and/or stimulate growth of tissue.

These stem cells are obtained from a patient’s pelvis area, which has a rich supply. The harvest is typically done in the office under local anesthesia. There are other stem cell types, obtained from fat or the umbilical cord – but these are not as well studied for treatment of orthopedic issues.

There is evidence that BMAC injections may improving healing of rotator cuff tears, when combined with arthroscopic fixation. BMAC injections may later the course of arthritis and potentially delay the need for joint replacement especially when combined with other therapies such as physical therapy, and anti-inflammatory medication.

 

Who is an ideal candidate for orthobiologic treatment?

As an emerging area of focus in orthopedic surgery, medical research in regenerative medicine remains a hot topic. Most of the research has been focused on knee osteoarthritis. There is also research on patients with cartilage and ligament injuries in the shoulder, elbow, wrist, hip, knee, and ankle.

Patients with mild to moderate joint arthritis, or those with tendon and/or ligament injuries can consider biologic treatments. Not only is it a non-surgical option, but for those people having surgery – their procedure can be augmented with biologic injections to potentially speed up and improve the post-operative healing process.

Recent studies suggest that both PRP and BMAC are effective in improving patient-reported outcomes in those with mild to moderate knee arthritis for at least 12 months.  PRP has been conclusively shown to be safe and effective for improvements in pain and function over this time frame. PRP has also shown efficacy in treating tennis elbow/lateral epicondylitis in the elbow and various tendinopathies.

Some studies examining PRP use with ACL reconstruction have shown that improved and faster ACL graft healing and incorporation into the body.

 

Who does it?

These injections are a service offered by multiple physicians at the Orthopedic Center of Illinois including Dr. John Watson, Dr. Varun Sharma, and others. Please call 217-547-9100 and ask for a consultation to discuss if you think this might be an option for you.