Orthobiologics Show Great Promise for Less Invasive Treatment of Certain Musculoskeletal Conditions

As orthopaedic medicine continues to advance through innovation, research and evidence-based medicine, the complexities and unknowns about newer treatments such as orthobiologics, may leave patients wondering if it is a viable treatment option for them. Orthobiologics, sometimes referred to as regenerative medicine, have shown great promise to treat conditions such as osteoarthritis; however, patients are seeking resources to understand if the treatment is right for them. To educate patients, the American Academy of Orthopaedic Surgeons (AAOS) developed an FAQ published on OrthoInfo.org, that outlines what orthobiologics are and the potential risks and benefits.

PRP), to leverage the body’s natural physiology, and help enhance the body’s healing process.ⁱ  According to the FAQ, orthobiologics can be used by orthopaedic specialists to:

• Help relieve pain and inflammation from certain orthopaedic conditions, such as early osteoarthritis, which may help delay or negate the need for surgery
• Enhance the body’s ability to heal from a repetitive use injury, such as a tendon strain or chronic anatomic change to the tendon known as tendinopathy
• In some cases, improve healing after orthopaedic surgery

AAOS recognizes the potential orthobiologics could have on the future of musculoskeletal patient care, but recommends the need for additional evidence-based research and education for physicians and clear information for patients.

“Many of my patients want to know more about orthobiologics and if it’s worth the hype,” said Jason L. Dragoo, MD, FAAOS, chair of the AAOS Devices, Biologics and Technology Committee and professor and vice chair of Academic Affairs for Colorado University Department of Orthopaedics in Denver. “While we are witnessing huge advancements in orthobiologics that have shown promise for patients suffering from knee osteoarthritis and tendinopathies, such as tennis elbow, I would encourage everyone to do their homework because it is not a viable treatment option for everyone. The regenerative therapies touted in radio ads or featured on highway billboards may not be grounded in science.”

Dr. Dragoo recommends patients work with a reputable physician, ideally one who does clinical research in this area and tracks their patient-outcome results. While trustworthy doctors can be found in many areas, if an orthopaedic surgeon is board certified and a fellow of the American Academy of Orthopedic Surgeons (FAAOS), it means they have met the rigorous professional and ethical standards established by AAOS. Dr. Dragoo also advises patients to:

• Avoid physicians who tout “stem cell therapy” or claim they can cure various musculoskeletal conditions in addition to pancreas, liver and kidney disorders, baldness and eyesight issues, as these violate the U.S. Food and Drug Administration (FDA) regulations on the use of biologics
• Speak to a physician about treatment options and then take the time to research those options, as well
• Ensure a physician conducts a full medical exam and inquiries about any systemic illnesses such as rheumatoid arthritis, lupus or cancer
• Determine if your insurance company will cover orthobiologic treatment, and if not, understand the out-of-pocket costs associated with the procedure

“There are still a lot of unanswered questions and until we have those answers, we should proceed with caution,” said Dr. Dragoo. “The AAOS is leading discussions with the FDA and other leading orthopaedic industry representatives to create evidence-based, unbiased information and guide advancements in the next five years that will help ensure more beneficial and targeted orthobiologic treatments for specific conditions.”