Orthobiologics Explode

Orthobiologics Explode

The orthobiologics field, which merges biological therapies with traditional orthopaedic healing and surgical techniques, is exploding. Why? Because in many circumstances, tissues can be induced to heal—or even re-grow—if the right environment is provided. Here is the latest.

We have now entered the Anabolic Era of orthopaedics. In the past, surgeons would resect (cut out) torn tissues and tell patients to come back when they needed a joint replacement. Today the preferred strategy for treating (or avoiding) arthritis is to repair, regenerate, and replace injured tissues as soon as possible.

Tissue engineering has been around for a long time. I was fortunate to invent one of the first commercially successful orthopedic tissue regeneration devices, called the collagen meniscus implant (CMI), in the 1980s. This collagen scaffold was designed to induce meniscus tissue to re-grow into a trellis-like material. It has now been used thousands of times worldwide.

Many tissues, however, require more than just a scaffold to re-grow into; they benefit from a stimulus. Nature’s stimuli are called “growth factors”—like the testosterone hormone that children acquire in puberty to spur their growth. There are more than 1,000 different types of growth factors in human blood, and each plays a role in tissue healing. Along the walls of blood vessels live specialized cells called “stem cells.” These cells are primarily growth factor engines. They migrate to the site of an injury in the body and release their growth factors, often instructing other cells to perform specific healing activities—such as laying down new collagen fibers or forming new cartilage matrices. As you age, the number and potency of these stem cells declines.

Fortunately, there are now numerous outside sources of growth factors and stem cells. Each has pros and cons in its use for stimulating tissue healing. An entire industry is growing around products to harvest and concentrate these factors for physicians’ use. There are avid proponents of each type, which come from a variety of sources. These include bone marrow (BMAC or bone marrow aspirate concentrate), fat (lipoaspirates), blood (PRP, or platelet-rich plasma), and the amnionic membrane and fluid from C-section births.

My personal bias is to use amnionic sources. Why? Because there are at least 45 times more stem cells in newborns than in adults. My older patients have very few stem cells in their bone marrow, and the amount of growth factors from their own blood varies widely. I get 2 to 50 times the concentration of growth factors from amniotic sources that I would from adult blood. Fat, while very vascular, requires a separate surgical procedure that most people would prefer to avoid.

I collaborate with an independent testing lab to test and confirm that each batch of the amniotic fluid I use has both live stem cells and active growth factors.

Each of these techniques of anabolic stimulation has reported successful outcomes across a wide variety of musculoskeletal disorders including tennis elbow, partial tears of rotator cuffs, partial ACL tears, tendonitis, degenerative disc disease, disc herniations, bone bruises, and Achilles injuries. The clinical data is accumulating more rapidly than for any previous new therapy I have seen in the field of orthopaedics.

After surgery, I use stem cells and growth factors, with their potent anabolic properties, to accelerate healing and to drive the healing of tissue toward normal regeneration rather than the formation of scar tissue. But what stem cells don’t do is turn into new cartilage. This means that they don’t actually cure arthritis, though they do mitigate the symptoms— in some patients dramatically, and for periods up to a year. The injections can be repeated without harm. In arthritic joints, stem cells release potent anti-inflammatory agents which reduce pain and may stimulate the production of more lubricating factors. These benefits seem preferable to the use of cortisone, which shuts down healing and injures tissues.

Since all my patients want to heal faster and diminish their downtime, return to sports and daily activities immediately, and jump higher and fly faster, the pressure to find novel ways to harness nature and use her hidden resources to accelerate healing is huge. We aren’t sure if we can accelerate it, but it sure is worth a try.

Comments ( 10 )

  • Richard Goad

    60 year old long term runner with nominal Lateral meniscus and articular cartilage .
    Had all treatments including Cartilage replacement “Carticel”. Early this year trialed “Nstride” injection. I am still able to run and wish to continue for as long as possible. Told I am to healthy and to young for knee replacement yet.

    Is there anything you have on trial that might extend my knee’s life ? I suspect the damage is to severe.

  • Aruna Dasandi

    I had arthoscopy done but as it has not work and they have suggested knee replacement which I do not want to do it. Do you think you can help?

    • Dan Smith

      There is a very good chance Adipose Treatment can help you, but it is of course important to have the appropriate diagnostic and consultation to ensure suitability, and discuss likely outcome.

  • Simon

    Hi Richard

    It’s possible that Adipose Tissue Therapy will help your condition. However the only way for us to be sure you are suitable for the treatment is have you assessed by one of our experienced clinicians. Please contact us directly to arrange an appointment.

    Regards

  • Barry Parkins

    Hi iI have Crohn’s disease but recently was diagnosed with osteoarthritis in both ankles. Can regen treatment treat this condition without surgical intervention

    • Simon Checkley

      Hi Barry

      Yes it can although you’d need to be assessed by one of our specialists before we could tell you if it would definitely work for your particular case.

      Regards

      Simon

  • My husband (82yrs) has Parkinsons, and osteoporosis has resulted in 5 of his vertebrae crumbling – he is now very bent over, and with the added problem of Parkinsons walking is hard – but he is very determined and continues to make himself walk. Might the stemcells help in either case?

    • Simon Checkley

      Good Morning.

      We are unable to treat Parkinsons currently although this is an area we are keen to explore.

      As for the Osteoporosis we maybe able to help but that is a decision for one of our clinicians to take after they have seen your husband.

      If you like to arrange a consultation please contact us.

      Regards

  • Chris Dellanzo

    I am 66 and about 5’8″ around 170 lbs. I have severe osteoarthritis of the hip and can walk about 9 holes of golf . Do you suggest hip replacement and what type or any other suggestions ?

    • Simon Checkley

      Hi Chris

      Thanks for your enquiry.
      You may well be suitable for a regenerative treatment such as Lipogems, which would avoid you having to undergo a hip replacement.
      If you give us a ring we can arrange for one of our clinicians to see you so we can assess your suitability.

      Regards

      Simon

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