Orthobiologics (Regenerative Medicine)

This information is useful for children and adults
doctor examining a knee exam, possibly to recommend orthobiologics, which can stimulate a faster, better quality of healing.
Why Yale Medicine?
  • Our doctors are improving the healing process for many patients with different orthobiologic treatments, including platelet-rich plasma (PRP).
  • Because we are an academic medical center, we have access to the latest updates on and newest approaches to using orthobiologics.
  • At our Center for Musculoskeletal Care, various types of specialists work side-by-side on your problem so they can advise you on best treatment choices.

One of the most difficult things about breaking a bone or tearing a ligament is waiting for it to heal. Sometimes it never heals fully. But here is some good news: Regenerative medicine treatments called orthobiologics may have the potential to help you heal faster and even better than traditional approaches. These are treatments that have been used by professional athletes, such as Mo Williams, Stephen Curry and Garrett Richards.

Orthobiologics have been used to treat patients without surgery, or to augment a surgical procedure and enhance healing after an operation. There are several different types available. A popular one is platelet-rich plasma (PRP), which harnesses natural connective tissue growth factors found in specialized blood cells called platelets. To treat a patient with PRP, the doctor draws blood, uses a centrifuge to separate out the platelets (think of them as healing cells), and then injects the platelet-rich solution into the patient’s body at the site of an injury.

If you are considering PRP or another orthobiologic treatment, there are some important things you should know. One is that while many patients have excellent results, doctors are still learning how orthobiologics work. Better research and patient data are needed before they can fully understand how to more precisely tailor different orthobiologics to treat particular injuries.

Dr. Ray Walls speaks to a patient about PRP

Credit: Robert A. Lisak

“For that reason, we strongly believe people should come to Yale Medicine—an academic medical center—for these treatments,” says Raymond Walls, MD, an orthopedic surgeon and associate professor in the Department of Orthopedics & Rehabilitation at Yale School of Medicine. “It is vital that patients are treated by expert physicians who are at the forefront of knowing about the latest research and best approaches to care throughout the world.”

 

There are different types of orthobiologics that doctors can use as nonsurgical treatments for bone and muscle injuries. Most are administered by injection into the site of an injury or via surgical procedure to potentially enhance recovery and promote a high quality of healing.

Examples of orthobiologic treatments, used for different purposes, are as follows: 

Platelet-rich plasma (PRP): The doctor takes a patient’s own blood and spins it in a medical centrifuge. This separates out the red blood cells, which are discarded, leaving a rich concentration of platelets and plasma cells. These cells are unique in that they contain growth factors that can stimulate healing in an arthritic knee, a sports injury or another painful condition. The whole process should take less than an hour. One PRP treatment may be sufficient, but some patients will need two or three treatments.

Bone marrow aspirate concentrate (BMAC): Yale Medicine doctors have used this orthobiologic treatment during surgery. It harnesses the patient’s own stem cells, which are powerful cells that can actually bond with the cells of a knee or ankle. On the day of surgery, the stem cells are extracted from the bone marrow in the patient’s pelvic bone once he or she is under anesthesia. The cells are then spun in a medical centrifuge to create a rich concentrate. The doctor then injects this substance back into patient’s body at the site of the surgery.