What are Orthobiologics or Biologic treatments?

This includes cells, blood components, growth factors, human donor tissue, and other naturally occurring substances that promote the body’s essential ability to heal and decrease inflammation

Are Biologic treatments safe?

Yes, additionally this is an area with heavy research interest in continuing to expand and provide effective treatment options for patients who qualify for biologic treatments

Our physicians recommend the safest and most effective biologic treatments based on the patient’s unique history and clinical condition

Biologic treatments available at our office

At OAZ our physicians offer biologic treatments to include platelet rich plasma (PRP) and cartilage transplantation for qualified patients

These biologic treatments can be used as a single treatment, to enhance surgical procedures, or as surgical procedures themselves in certain scenarios.

Who is a candidate?

PRP injections:

• Current research suggests that the best patients to undergo PRP injections fit into three broad categories
  1. Patients with early stage osteoarthritis
  2. Patients with persistent tendon injuries
  3. Patients undergoing surgery related to either early stage osteoarthritis or persistent tendon injuries to enhance the healing process
• Additionally, they have exhausted all other non-operative treatment strategies including activity modification, physical therapy, corticosteroid injections, bracing but have not fit the criteria for joint replacement or other surgeries
• PRP injections are not typically recommended for patients with endstage or “bone on bone” arthritis

Cartilage transplantation:

• Current research suggests that the best candidates are patients less than 45 years of age with limited or focal cartilage damage in an otherwise healthy joint
• These patients should not have a severely elevated BMI and do not have severe co-morbidities like rheumatoid arthritis or other autoimmune arthritic conditions

What are specific conditions that we recommend biologic treatments for?

After a thorough evaluation by our physicians we typically recommend biologic treatment for:

• Early stage osteoarthritis or cartilage damage of the knee, hip, shoulder, elbow, or ankle joint
• Focal or diffuse articular cartilage damage
• Tendon injuries to include:
  1. Shoulder: Rotator cuff
  2. Elbow: Tennis elbow
  3. Hip: Gluteus medius/minimus tears, proximal or midbody hamstring tears
  4. Knee: Quadriceps tendon, patellar tendon
  5. Lower leg: Achilles tendon, plantar fasciitis
• Ligament injuries

Biologic injections available at our office

Platelet Rich Plasma (PRP): A patient’s blood is drawn and then placed in a special device called a centrifuge to separate the platelets and growth factors essential for healing the damaged area. These isolated platelets and growth factors are then injected into the damaged area. In certain situations, PRP can be injected into the surgical site to aid in the healing process

Cartilage Transplantation surgical procedures available at our office

These procedures are typically reserved for the knee but there are isolated applications of these surgical procedures in other joints like the shoulder and elbow

Osteochondral Autograft transplantation: This surgery is reserved for patients with relatively small area of cartilage loss. A small area of a patient’s own healthy cartilage and bone is harvested in a non-weightbearing region and transplanted to the area of cartilage loss recreating the cartilage and bone surface

Osteochondral Allograft transplantation: This surgery is reserved for patients with relatively large areas of cartilage loss. Donor cartilage is shaped to fit perfectly into the patient’s area of cartilage loss recreating the cartilage and bone surface

Matrix-Induced Autologous Chondrocyte Implantation: This is a two-stage procedure that requires a diagnostic arthroscopy in the first stage to harvest cartilage from the patient’s knee. These cartilage cells are then grown in a lab where they are later implanted during the second stage surgery.

Meniscus Transplantation: This surgery is reserved for patients who previously had their meniscus removed surgically due to injury and now have persistent knee pain and swelling. A donor size-matched meniscus is arthroscopically sewn in place acting as the new meniscus.

Insurance considerations

Some of these procedures are still considered investigational (experimental) by insurance carriers and may be a self-pay service only.