Orthobiologics is used to describe regenerative agents used to treat orthopedic and musculoskeletal disorders. This includes PRP (platelet-rich plasma) and BMAC (bone marrow aspirate concentrate).
Orthobiologics, such as PRP and BMAC, can be used to treat a diverse range of orthopedic and sports injuries, both acute and chronic. This includes potentially repairing damaged tissues such as muscle, tendons, ligaments, and cartilage, as well as reducing osteoarthritis pain and improving function.
Our bodies have an innate ability to heal themselves, but conventional medicine has traditionally been aimed at rushing this process, leading to a suboptimal repair. What we now realize, is that with a little redirection, we can queue the body to do what it is designed to do.
This is accomplished by taking the healing growth factors which naturally exist in our body’s blood and bone marrow, concentrating them and placing them in the injured area. The cells then change the environment into one which optimizes healing with a more native cell type. Of course, the concentration of the different types of cells must be carefully determined by the regenerative medicine specialist, as each location and type of injury requires specific formulation.
What is regenerative medicine?
Regenerative medicine is defined as the process of replacing or “regenerating” human cells, tissues, or organs to restore or establish normal function. This growing area of medicine seeks to put the body’s own repair mechanisms to work healing damaged tissues and organs.
At Orthopedic Associates of Long Island, we focus on two proven regenerative therapies for treating orthopedic and musculoskeletal disorders: platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC).
What are the benefits of regenerative medicine?
Our bodies have amazing healing abilities. Regenerative medicine simply relies on those processes to have the body heal itself. The goal of regenerative medicine is to replace, or restore, human cells, tissue, or organs. This will return normal function and reduce or eliminate pain. Orthobiologics is the use of regenerative PRP and BMAC to treat orthopedic and musculoskeletal disorders.
These are some benefits of using orthobiologics/regenerative medicine for your orthopedic recovery. We find that these processes help your body:
- Heal injuries faster.
- Repair damaged tissues.
- Reduce pain levels.
- Improve function.
Who is a good candidate for regenerative medicine treatment at Orthopedic Associates of Long Island?
Regenerative medicine doesn’t prove effective for all patients. But it is one of the tools we may use if we feel your situation is right. BMAC and PRP may be used for these injuries and conditions:
- Tendon injuries, including tendonitis, rotator cuff injuries, and tennis elbow
- Arthritis and cartilage injuries
- Plantar fasciitis
- Muscle strains
- Ligament sprains
What is platelet-rich plasma?
We all know the role platelets in our blood play in healing wounds. Platelets work to clot the blood and close the wound. But they have a far greater role in healing than simply clotting. Platelets also have numerous growth factors that work to kick start the healing process of rebuilding the tissue after the wound is first closed.
Our blood has three types of cells: red blood cells that carry oxygen to the body, white blood cells that fight infection, and platelets that help blood clot and work to heal injuries. Plasma is the fluid part of our blood.
The idea behind platelet-rich plasma is that by concentrating a sample of blood and removing the red blood cells, what’s left is a concentrated plasma with platelets and white blood cells. This concentration expanded healing power.
How does PRP work?
When you have a wound or injury, such as a strained ligament, the body sends platelets to the area. With wounds, the platelets first form the clot to prevent more bleeding. Platelets then create a foundation for new tissue to grow. They also release growth factors and other proteins. These proteins attract stem cells and other cells to the area. All of these various cells, proteins, and growth factors work together to rebuild the injured tissue to fully heal and repair the injury. Even though a strain or tear isn’t visually damaged outwardly, the body’s response to begin repairs is the same.
By concentrating platelets and their corresponding growth factors into PRP, this elevates the healing potential. When concentrated PRP is injected into the injured areas, they act like glue. They bind the damaged tissue together. The PRP also release growth factors that stimulate the body’s natural healing response.
How is PRP made?
Creating PRP from your blood is a simple, fast process. We draw some blood, similar to what would be taken for lab work. The blood is then placed into a centrifuge that separates the blood into platelet-poor plasma on top, platelet-rich plasma in the middle, and red blood cells on the bottom. The PRP has the least volume of the three separated sections. It is now rich with platelets, white blood cells, growth factors, and proteins.
What is bone marrow aspirate concentrate?
Bone marrow is the tissue inside our bones. Blood cells are made in the bone marrow. Bone marrow has stem cells and many other cells that help in healing. When you have an injury or illness, stem cells help tissue heal and regenerate. The idea is that cells found in bone marrow can be used to treat damaged tissue, improve function, and help reduce pain.
Bone marrow aspirate concentrate (BMAC) is a concentrated form of bone marrow. Compared to typical bone marrow, BMAC has more regenerative cells, including stem cells. It also has platelets and growth factors like those found in PRP.
Why are stem cells important here?
Stem cells are powerful cells that have unique capabilities. Stem cells can:
- Copy, or replicate themselves.
- Secrete anti-inflammatory proteins.
- Turn into different types of cells, such as cartilage, bone, and tendon.
How is BMAC made?
Bone marrow aspirate concentrate uses bone marrow that is usually taken from the back of your pelvic bone. The process takes from 30 to 60 minutes, depending on how much bone marrow is to be drawn. You lie on your side or stomach and here’s the process of creating BMAC:
- We locate the pelvic bone either by touch, ultrasound, or a fluoroscope.
- We disinfect the skin.
- We apply local anesthetic from the surface skin down to the bone.
- Using a special needle, we enter the bone.
- The needle withdraws (aspirates) the marrow from your bone.
- The bone marrow is placed in a centrifuge. This removes much of the fluid and other unwanted components. What’s left are concentrated bone marrow cells, BMAC.
What are the risks and side effects of regenerative medicine?
After we inject BMAC or PRP into a joint, it is normal to have some pain and mild swelling in the area for several days. After injections into a soft tissue, you will have some pain and mild swelling that can last a couple of weeks.
The main complications of these treatments are possible allergic reactions, bleeding at the injection site that doesn’t stop within 10 minutes, and infection. There is a rare risk of injury to a nerve, but this is usually temporary.