Orthobiologicals
Orthobiologicals
What are Orthobiologicals?
Synthetic or organic substances that help in the recovery of musculoskeletal injuries are generically called Orthobiologicals, grouping together different products that have in common the ability to accelerate tissue healing.
These regenerative treatments aim to increase the longevity of osteoarticular structures, preserving their function and integrity and minimizing the necessary interventions, through minimally invasive application techniques.
As a result of technological advances that require strict usage criteria, the products currently used can act in areas other than musculoskeletal pathologies, namely in bone, tendon, muscle or ligament regeneration, as well as in the repair of cartilage injuries.
Bone regeneration
Bone regeneration
There are clinical conditions that benefit from supplementation with substances that help regenerate bone structures, such as the absence of consolidation of fractures or bone defects after trauma, infection or tumors.
Although bone graft is still the most widely used, bone marrow aspirate concentrate (BMAC), recombinant human bone morphogenetic proteins (rhBMP) and demineralized bone matrix (DBM) have been demonstrating a relevant role as adjuvants to achieve bone consolidation.
Other products, such as stem cells and microRNA gene therapies, are being developed in this area with promising results.
Ligament reconstruction and regeneration
The use of Platelet Rich Plasma (PRP) alone or in conjunction with surgical repair of injuries to the cruciate or collateral ligaments of the knee, elbow and other locations is under study and has not yet revealed a significant effect on healing time or return to sports.
PRP is a product derived from the patient’s own blood, subjected to a centrifugation process and from which a platelet-rich fraction is removed, rich in substances that promote healing and tissue regeneration.
The concentration and formulation of the preparations may have a preponderant effect and still require more conclusive studies to understand the true potential of this therapy in ligament injuries.
Orthobiologicals in the elbow
Platelet-Rich Plasma (PRP) has been studied in the treatment of lateral (especially) and medial epicondylitis of the elbow, with results that indicate an improvement in pain and function superior to conventional treatment with corticosteroid injected into the site.
For tendonitis of the biceps brachii and triceps, the results with PRP were promising but not entirely conclusive, so further studies are needed to assess its relevance in this pathology.
Orthobiologicals in the shoulder
Stem cells obtained from local adipocytes (fat cells found inside the shoulder) have been used as an adjuvant in surgical repair of rotator cuff tears, improving tendon healing and reducing post-operative pain. Platelet-Rich Plasma (PRP) also appears to influence the tendon’s healing capacity, and is also an alternative for rotator cuff tendonitis that remains painful even after physiotherapy treatment.
In rotator cuff repair surgery, PRP has also been shown to improve healing rates, with a favorable impact on functional outcomes. PRP formulations may differ depending on the manufacturer and patient-related factors, so it is important to choose those that have shown the best results in studies.
Gene therapy with substances aimed at modifying the genes responsible for tendon degradation or regeneration is an area of great interest but still at an early stage of research.
