PRP, Stem Cells & More: Which Orthobiologic Treatment Is Right for You?

When joint pain, tendon injuries, cartilage damage, or sports injuries start limiting day-to-day activities, patients start considering options beyond the conventional ones. The use of orthobiologics in modern orthopaedic surgery is an emerging topic of debate, with platelet-rich plasma (PRP), bone marrow-derived therapies, and other regeneration therapies being discussed.

But what treatment is right for you? 

This depends on the nature and extent of your injury, your overall health, the desired outcome of treatment, and the expert opinion of your orthopaedic surgeon. Dr Ankit Meshram specializes in conducting a thorough examination of the individual patient and suggesting a suitable treatment plan.

What Are Orthobiologics?

Orthobiologics are biological products or treatments that are employed in orthopaedic (bony) medicine to have a therapeutic effect on the body's natural healing process. They can be used to treat some tendon, ligament, muscle, cartilage, and joint diseases. Unlike one-size-fits-all therapy, the treatment with orthobiotics is usually chosen based on the injury and the patient's needs. These are commonly discussed orthobiologic options:

• Platelet-rich plasma (PRP)
• Bone marrow-derived therapies
• Cell-based treatments
• Autologous blood-based products
• Other biologic materials used in orthopaedic procedures.

These treatments are not guaranteed to regenerate or make surgery unnecessary for all patients. This depends on which condition they are treating and their potential benefits.

PRP: What Is It and who May Benefit?

Platelet-rich plasma (PRP) is created from the patient's blood. A sample is collected and concentrated to make platelets and other products before being injected into the desired area. Platelets have growth factors and signaling proteins that play a role in tissue repair. PRP is sometimes recommended for some soft tissue and musculoskeletal conditions, due to the fact that it is made from a patient's own blood. PRP can be discussed for the following conditions:

• Tendon-related injuries
• Certain ligament injuries
• Selected sports injuries
• Certain types of joint pain
• Certain degenerative musculoskeletal conditions 

But not all patients are suitable for PRP treatment. The concentration and preparation of PRP are variable, and results may be different based on the condition, treatment protocol, and the individual patient.

What About Stem Cell Treatments? 

Stem cell therapies for the treatment of regenerative medicine have attracted much attention in the field. Under the right biological conditions, stem cells have the ability to develop into many different kinds of cells, hence their use in musculoskeletal medicine. But the term stem cell treatment encompasses various methods, and not all treatments advertised as stem cell treatments are created equal or supported by scientific evidence or FDA approval. There are some orthobiologic treatment that involve cells or the biological material from sources like bone marrow. The effectiveness of these treatments depends on the person and the treatment being used. Patients should therefore consult with a qualified orthopaedic specialist for evidence-based information, anticipated results, limitations, risks, and regulatory information before going forward.

PRP vs Stem Cells: Is One Better? 

There's no one universal solution. PRP and cell-based therapies are different in their action and may be indicated for different clinical circumstances. Do not select just on the basis of the "more advanced" treatment. One patient with an identified tendon issue may be suitable for PRP, whereas a patient with a more complicated orthopaedic condition may be a good candidate for an entirely different treatment plan. A specialist may consider:

• The exact diagnosis
• Location of the injury
• The degree of damage to the tissues.
• How physically active they are and their age.
• Previous treatments
• Imaging findings
• Overall health
• Treatment expectations

This personalized evaluation will help to decide if an orthobiologic therapy is indicated at all.

Orthobiologics Are Not Always the First Choice 

It is crucial for patients to be aware of one of the most significant lessons: Orthobiologics are not the optimal treatment for every orthopaedic condition. Treatment can range from physiotherapy to activity modifications, medications, conventional injections, rehabilitation or surgery depending on the diagnosis. In some instances, the use of orthobiologics may be part of a multi-modal approach to treatment, rather than a single treatment. A correct diagnosis should precede a procedure.

How Does a Doctor Decide Which Treatment Is Right?

Typically, the first step is a comprehensive consultation. Your orthopaedic surgeon will check your symptoms, medical history, previous treatment, physical examination, and the results of X-rays and other diagnostic tests. If a sports injury or long-term joint pain has occurred, it is especially crucial to know the reason behind the issue. Treatment of symptoms alone without correction of underlying biomechanical and/or structural factors may not result in the desired long-term outcome. Dr. Ankit Meshram can evaluate the patient's particular case and discuss the possibility of an orthobiologic approach if it is suitable for the patient.

What Should You Ask Before Orthobiologic Treatment? 

When considering PRP or stem cell-based therapy or other orthobiologic options, patients must ask themselves:

• What will my actual diagnosis be?
• What is the purpose of the treatment?
• Do there seem to be good reasons to believe that I have a specific condition?
• What are my chances of winning?
• Are there other methods of treatment?
• What are some possible dangers and restrictions?
• What might be the number of treatments needed?
• What will be the recovery and rehabilitation plan?

These points can assist patients to make the right decision and not just go with the hype.

The Bottom Line

PRP and other orthobiologics like stem cells are a developing field of orthopaedics. These treatments can be used for some musculoskeletal conditions, but there is no one-size-fits-all orthobiologic treatment for everyone. The first step is to make a proper diagnosis and discuss treatment options specifically with the patient. Treatment, rehabilitation, orthobiologics, surgery or a combination of treatments and procedures may be suitable depending on your condition. If you want to consider treatment for joint problems, injuries related to sports, problems with the tendons, or any other orthopedic conditions with regenerative medicine, consulting a knowledgeable professional such as Dr. Ankit Meshram would be helpful for you to get more information about it.