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Sorting Out the Alphabet Soup: Understanding Orthobiologics for Better Healing

January 30, 2020

As avid PRC blog readers know (and hello to both of you!), I spent the first quarter of my life riding every horse in southwestern Pennsylvania, mixed in with a smattering of other country girl outdoor activities. As a result, I graduated college with a hefty amount of chronic sciatica, a few broken bones, and the gentle warning from my doctor that I would likely wear out my body if I continued living life so energetically. With how I grew up, having chronic pain didn’t surprise me; everyone in my town did as well. What I was surprised to hear, however, was that medicine was rapidly evolving to develop relief for the millions of Americans suffering from orthopedic pain.

What are orthobiologics?

According to the American Academy of Orthopaedic Surgeons, orthobiologics are “substances that orthopedic surgeons use to help injuries heal more quickly.” Physicians use these to improve the healing of anything from broken bones and injured muscles to tendons and ligaments. Unlike other pain-relieving injections, these products are made from a patient’s own cells. Fascinatingly, when these cells are highly concentrated, they help speed up the healing process for orthopedic or musculoskeletal problems.

In January’s episode of Mondays with Mel (hello again!), Dr. Trevor Turner explains that orthobiologics help to overcome two key orthopedic challenges: First, trying to treat people with minimal invasion, and second, using orthobiologics to ensure that if a patient requires surgery, they face the best possible outcome. Put another way, orthobiologics presents a better way to undergo and recover from surgery, as well as a potential surgical replacement.

“We’re really starting to look at how we offer people better function with less risk for a longer amount of time,” Dr. Turner said. “As medicine changes and we’re starting to emphasize value-based care, that is, looking for the best outcomes at the least cost, orthobiologics will increasingly come to be an essential part of the way we manage orthopedic and musculoskeletal problems for the long term.”

Researching New Ways to Care

In the last decade, medical research concentrated on understanding why a patient’s own cells are so powerful in their healing, as well as learning which cells are best for healing which ailments. These cells, which range from stem cells to platelets, are easily extracted and can be concentrated into platelet-rich plasma (PRP). PRP procedures, like many orthobiologics procedures, have high success rate, but aren’t the only option for patients.

Another common procedure is BMAC, or bone marrow aspirate concentrate, in which a physician harvests stem cells from bone marrow and then uses a concentration of those cells as an injection for a joint, tendon, or ligament tear. During the podcast, Dr. Turner also shares how French scientist Philippe Hernigou found that if you combine bone marrow concentrate with the tendon bone interface, the re-tear rate drops to 13% ten years post-surgery. This presents a significant improvement from the typical re-tear rate for some shoulder surgeries, which can be up to 50% in the first year.

Healthcare innovation like orthobiologics not only presents incredible healing alternatives, but also an opportunity for a better patient experience. As patients who previously faced risky surgery can rely on alternative care with much faster recovery time, they spend less time in the hospital and more time getting their life back.

“In medicine, there’s some things we don’t do as well as the human body was designed to do,” Dr. Turner said. “Unlocking a person’s innate own ability to use part of their body in another part of their body to give them the best outcome over time is profound and fun and tremendously rewarding.”

Sources and Further Reading:

Healthcare Innovation with Dr. Trevor Turner

Helping Fractures Heal (Orthobiologics)