Orthobiologics
If your injury or condition isn’t improving with traditional orthopedic treatments like physical therapy or cortisone injections, orthobiologics may be a promising alternative. Orthobiologics are substances derived from your own body or other natural sources that enhance natural healing processes. They are used to promote healing and regeneration of musculoskeletal tissues, including bones, joints and muscles.
At Atrium Health Musculoskeletal Institute, we offer several types of orthobiologic treatments to help you get back to the activities you love. Our orthopedic and sports medicine specialists thoroughly evaluate your condition and develop a tailored treatment plan that’s best for you, including follow-up appointments and post-treatment rehabilitation.
Same- and next-day appointments available.
Conditions treated
We treat the following conditions and injuries:
- Ankle arthritis and cartilage defect
- Ankle sprain/ligament injury
- Biceps tendonitis
- Elbow pain and problems
- Frozen shoulder
- Glenohumeral arthritis
- Greater trochanteric bursitis/gluteus medius tendinopathy
- Hamstring injuries
- Hip problems
- Knee osteoarthritis and chondromalacia
- Knee problems
- Lateral epicondylitis (tennis elbow)
- Medial epicondylitis (golfer's elbow)
- Partial/low-grade ulnar collateral ligament (UCL) injuries
- Partial or interstitial rotator cuff injuries (or tendinopathy)
- Patellar tendonitis (jumper's knee)
- Patellar/quadriceps tendinopathy
- Plantar fasciitis
- Quadriceps tendonitis
- Shoulder labral tear/SLAP (superior labrum anterior to posterior) tear
- Shoulder tendonitis
- Tendinitis
- Tendinosis
Orthobiologic treatments
Platelet-rich plasma therapy
Platelet-rich plasma (PRP) therapy is increasingly used to treat injuries in ligaments, tendons and cartilage. Additionally, it is proving effective in addressing osteoarthritis in various joints like the hip, knee and shoulder.
During PRP therapy, the patient’s blood is drawn and spun in a centrifuge, a process that separates the various components of the blood. This isolates the platelets, the most active component in the blood, from other blood cells. The platelet-rich solution is then injected into the area of the body that needs to be treated. This is usually done with the guidance of an ultrasound device or X-ray.
At this time, insurance does not provide coverage for PRP therapy; it is a self-pay procedure.
Platelets found in the patient’s own blood contain growth factors that stimulate the body’s natural healing process, aiding in the repair of injured tendons or cartilage while also lessening inflammation. This can lead to decreased joint fluid inflammation, reducing pain and improving overall function.
PRP therapy supports tissue reorganization (or remodeling) and offers an effective solution for those who haven’t found significant relief through traditional treatments.
PRP therapy can help patients with chronic orthopedic conditions or injuries avoid or postpone surgery. This can be beneficial for athletes who want to avoid a potentially career-ending or career-altering surgery.
Lipoaspirate
Adipose-derived cell therapy uses fat collected from your body (lipoaspirate), which contains a high concentration of important cells called mesenchymal stromal cells (MSC) alongside various growth factors. Under certain conditions, these cells have the potential to generate new tissue like bone, cartilage, fat and blood vessels.
Fat can be collected from numerous areas of the body through a procedure similar to liposuction, most commonly from the abdominal wall or the back of the hip/gluteal region.
Lipoaspirate is collected from your body through a minimally invasive procedure (involving a small puncture in the skin). The collected fat is then delicately processed and purified. The procedure is typically done under local anesthesia, either with or without light sedation, and may take place in a clinic procedure room or in the operating room.
Risks are rare, but may include:
- Bleeding
- Bruising at fat harvesting site
- Infection
- Accidental puncture of the inner abdominal wall, potentially requiring surgical repair
- Persistent pain after the procedure
Experts are still determining how lipoaspirate works within the body (mechanism of action), as well as how well it works (clinical efficacy). Nonetheless, experts do believe that injecting live mesenchymal stem cells (MSCs) and growth factors into affected joints or other areas in the body promotes pain reduction and enhanced function. Numerous studies have verified the safety of this procedure. However, experts believe that the cells in lipoaspirate decrease (modulate) inflammation, can help reduce pain and improve function. It also has the potential to form new tissue, although this is still under investigation. Numerous studies have verified that the procedure is safe.
Bone marrow aspirate concentrate
Bone marrow concentrate (BMC), also known as bone marrow aspirate concentrate (BMAC), is a fluid containing cells taken from bone marrow, including mesenchymal stem cells (MSCs). Bone marrow is the soft, spongy substance that fills the inner cavities of bones. It is where blood is produced.
Tiny spaces in the bone marrow hold blood and stem cells, the primitive cells that are able to grow into various types of cells. Under certain conditions, some of these cells can also create new tissue like bone, cartilage, fat and blood vessels.
The first step in producing BMC is to collect bone marrow aspirate through a minimally invasive method that uses a needle to remove bone marrow from a large bone, such as the pelvic bone. The procedure is generally done under local anesthesia, with or without light sedation in a clinic procedure room, or in the operating room. The aspirate is then put through processing that uses a centrifuge.
Bone marrow processing methods vary widely and can affect the number and quality of cells.
Risks are rare, but may include:
Bone marrow aspirate indications can serve as a surgical aid to promote healing, particularly for bone and cartilage surfaces. This has been used for cartilage repair, cartilage restoration, joint preservation procedures, core decompression and other surgical procedures. Moreover, this approach can be applied across various joints with arthritis and soft tissue structures.
Experts are still determining how BMC works within the body (mechanism of action), as well as how well it works (clinical efficacy). However, experts do believe that BMC decreases (modulates) inflammation and it can potentially help reduce pain, improve function and help new tissue form. Numerous studies have verified the safety of this procedure.
Physicians Who Specialize in Orthobiologics
For a list of all sports medicine providers, visit here.
Frequently Asked Questions
The time it takes to see results can vary depending on the type of orthobiologic used and the condition being treated. During your consultation, you and your physician will develop a specific care plan related to your condition and symptoms.
The duration (length of time) of the effects varies among individuals and depends on the type of orthobiologic used, the condition being treated and your overall health.
Orthobiologics made from your own body usually have a low chance of causing problems.
Yes, orthobiologics are commonly used to manage symptoms of osteoarthritis and promote joint health.
A consultation with an orthopedic provider is essential to determine if you’re a good candidate for orthobiologics.