Regenerative Medicine

Concept art of a doctor and above his hands shows the text regenerative medicine
Orthobiologics is a term used to describe treatments involving using a patient’s own cells to facilitate healing, decrease pain and improve function. This includes Platelet Rich Plasma (PRP) and stem cells. Stem cells can be harvested from bone marrow (Bone Marrow Aspirate, or BMA) or adipose tissue (Adipose Derived Stem Cells, or ADSM).

Orthobiologics 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. However, with many injuries, there is not the proper environment to allow this healing. Orthobiologics aims to create a more favorable healing environment in the injured area of the body. This is accomplished by taking the healing growth factors which naturally exist in our body’s blood cells, bone marrow and/or adipose tissue, and after processing of the cells, injecting them into 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.

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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, our regenerative medicine specialists offer platelet-rich plasma (PRP), bone marrow aspirate (BMA) and adipose-derived stem cell (ADSM) treatments.

benefits of regenerative medicine

Our bodies have amazing healing abilities. Regenerative medicine relies on those processes to have the body heal itself. The goal of regenerative medicine treatments in orthopedics is to facilitate tissue healing, decrease pain and improve function by using cells from the patient’s own body. This will return normal function and reduce or eliminate pain. Orthobiologics is the use of regenerative PRP and BMA 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:

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  • Heal injuries faster.
  • Repair damaged tissues.
  • Reduce pain levels.
  • Improve function.

candidates for A regenerative medicine treatment at Orthopedic Associates of Long Island

Regenerative medicine treatments are used to treat the following conditions:

  • Tendon injuries, including tendinopathies (tennis/golfer’s elbow) and partial tears
  • Osteoarthritis
  • Cartilage injuries
  • Ligament injuries
  • Plantar fasciitis
  • Muscle strains
  • and many others

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.

An image of a medical professioanl hold a vile of platelet-rich plasma with gloves on.
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 platelet-rich plasma made?

A doctor drawing blood from a patient who's sitting down.
We draw some blood, similar to what would be taken for lab work. The blood is then processed in a centrifuge to separate out the red and white blood cells from the platelets and plasma. Depending on the condition being treated, some white blood cells may be added back in to the final preparation.

What is bone marrow aspirate?

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 (BMA) is a concentrated form of bone marrow. Compared to typical bone marrow, BMA has more regenerative cells, including stem cells. It also has platelets and growth factors like those found in PRP.

How is BMA made?

Bone marrow aspirate 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 BMA:

  • 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, BMA.

How is ADSM made?

Similar to bone marrow, adipose tissue is rich in stem cells. Adipose tissue can be harvested from a patient’s abdomen, flank or buttocks. Your doctor will determine the best location. This is done in office under sterile conditions. Here is the process for harvesting adipose tissue:
  • Patient is prepped with sterile coverings and area is cleaned
  • Local anesthetic provided
  • Special type of fluid called Tumescent Fluid is injected into the area where to be harvested. This helps to numb the area as well as constrict the blood vessels. This makes the procedure pain free with no loss of blood.
  • After injected the tumescent fluid, it takes about 10-15 minutes for full effect
  • Proper amount of adipose tissue is harvested from the site
  • Adipose tissue is processed to remove oils and other unwanted cells.
  • Remaining tissue is placed in centrifuge to concentrate the stem cells
  • Injection of the adipose derived stem cells into the injured area.
  • Steri strips and a bandage are placed over the harvest site. No suturing is needed.
  • PRP is typically added as well in order to increase the amount of platelets and growth factors

risks and side effects of regenerative medicine

After the regenerative medicine treatment, there can be increased pain and soreness for a few days. As with any injection, there is a small infection risk. Since a patient’s own cells are used for the procedure, there is no allergic response or rejection of the treatment by their bodies. Wish stem cells treatments, there is a small chance of developing a collection of blood called a hematoma. This can cause pain and soreness, but typically resolves quickly.

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.

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If you’re interested in learning more about regenerative medicine please contact us for a consultation at 631.689.6698 or fill out our contact us form here. We will discuss your needs and concerns, and determine your best course of action.

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