Orthobiologics is an area of medicine focused on harnessing the body’s natural ability to heal itself from injuries and disorders of the spine, joints, and musculoskeletal system. Orthobiologic treatments are an alternative to surgery that deliver to the anatomical site of an injury specific types of the body’s own cells which are processed to enhance their innate healing properties.  When precisely delivered to the site of an injury, these cells use the body’s natural response to injury to stimulate and support the repair process.

The Premier Commitment to Optimal Regenerative Medicine Outcomes

Optimal outcomes depend on a foundation of a comprehensive and accurate diagnosis, selection of the most appropriate treatment option, use of precision methods to prepare any use of biologic materials, and precision delivery, using appropriate image guidance for precise targeting of the anatomic pain generator(s). Advanced imaging techniques include ultrasound and fluoroscopy to assure that a patient’s orthobiologic payload is injected exactly where it is needed for maximum effect. This requires time, care, patience, planning, and expertise–a commitment Dr. Saeger makes to every patient.

Benefits Of Orthobiologics

Although this is an emerging field of medicine, and the safety and efficacy of these procedures are still being studied by clinicians, the growing consensus is that the field has some key advantages over traditional treatments like surgery for many conditions.  The field of Orthobiologics is less invasive than surgery and is done in the outpatient setting with no incisions. The risks of infection and complications are therefore lower and recovery time is minimal.

Orthobiologic Treatments

The two most common Orthobiologic treatments are platelet-rich plasma (PRP) therapy and bone marrow aspirate concentrate (BMAC) therapy.  BMAC therapy uses adult Mesenchymal Signaling Cells (commonly, but often inaccurately, referred to as “stem cells”) which have the unique ability to trigger differentiation or enhanced growth of a wide range of “resident” cell types after being injected, driving healing and promoting recovery and/or regeneration of damaged or degenerative tissue.

Platelet-rich plasma (PRP) therapy is a procedure using a patient’s own blood, drawn and processed to contain a much higher concentration of platelets than would normally be present. Platelets, which play a critical role in clotting, are a specialized type of blood cell involved in injury healing that also contain large reservoirs of natural growth factors that are essential for cell recruitment and multiplication involved in wound healing.

PRP is made using a centrifuge that separates the blood components. Unwanted elements are discarded, keeping the platelets, growth factors, cytokines, and plasma that are used for PRP. As a concentrated source of autologous platelets, PRP contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue. The normal concentration of platelets circulating in blood is 200,000 per microliter. The platelet count in PRP is about 1,000,000 platelets per microliter, a 5X concentration.

Growth and healing factors found in PRP:
  • Platelet Derived Growth Factor (PDGF)
  • Fibroblast Growth Factor (FGF)
  • Vascular Endothelial Growth Factor (VEGF)
  • Interleukin 8 (IL-8)
  • Transforming Growth Factor Beta (TGF-b)
  • Insulin like Growth Factor 1, 2 (IGF-1,2)
  • Epidermal Growth Factor (EGF)
Platelet-rich plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) therapies may be used to manage a wide range of acute and chronic injuries and musculoskeletal disorders, including:
  • Acute ligament, tendon, and muscle tears
  • Chronic arthritis
  • Tendinitis or tendonosis
  • Tennis elbow
  • Cervical radiculopathy
  • Herniated discs
  • Degenerative disc disease
  • Sciatica

Why I recommend BMAC as the primary autologous biologic for most conditions.

While we often do combine BMAC with PRP and A2M as supplements, BMAC is what delivers the so-called “stem cells” or, more accurately, the mesenchymal signaling cells that induce regenerative and healing processes and have the potential for modifying degenerative disease processes. BMAC also contains the highest concentration of platelets, growth factors, and cytokines essential for regeneration. While somewhat more invasive and initially more expensive, the superior results with BMAC make it ultimately more cost effective. In most cases, BMAC yields a more efficient pathway to the desired outcomes of pain relief and improved function.


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