Biologics for Knee Issues: Fact vs. Fiction

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"Biologics" involves using growth factors or biological products such as stem cells and platelet-rich plasma (PRP), substances naturally made by your body, to help treat and heal various health conditions. In orthopedics specifically, orthobiologics, a subset of biologics, can be used as an alternative treatment to care for a wide range of knee and other orthopedic conditions that might be causing pain or disability. Relative to some more conventional orthopedic treatments, orthobiologics is one aspect of medicine that hasn't been around for centuries. As a result, some misconceptions exist about what orthobiologics treatments can and cannot do for people with knee conditions.

Before I begin to separate fact from fiction regarding orthobiologics for the knee, it's essential to understand how these treatments work. Knee conditions characterized by a breakdown of cartilage often result in significant knee pain and disability for many people affected by them. At the most basic cell level, that cascading decline of cartilage health can't be combatted by the body secreting enough of its own new material to fix the problem. It's like trying to plug holes in a boat with a piece of tape. This is where the promise of orthobiologics can become a viable treatment option.

Orthobiologics involves the use of growth factors used to activate and stimulate the growth of new tissue in place of damaged tissue and protect healthy living tissue against future degeneration. Growth factors such as PRP and Bone Marrow concentrate and stem cells can promote the growth and repair of damaged tissue in the knee while protecting cells from dying. Such a treatment modality can be viewed as both healing and protective. The benefits of orthobiologics, especially growth factor treatments, can include the prevention of osteoarthritis later in life and preventing further damage after an orthopedic sports injury.

With a basic framework for understanding what orthobiologics is, its intended purpose, and its promise, let's check out some facts vs. fiction about biologics in general:

FACT: The goal of biologics is to use the body's healing power to overcome knee injuries, restore knee function, and protect the knee from degenerative damage in the future.

FICTION: Embryonic stem cells are used as "regenerative medicine" or biologics treatments. On the contrary, most legitimate, physician-lead medical practices use the patient's own stem cells in their biologics treatments.

FACT: Biologics can be a helpful treatment tool in helping some patients delay the need for surgery, especially total knee replacement.

FICTION: Biologics treatments are invasive and painful. In fact, one of the most significant benefits of biologics treatments for knee conditions is that they are far less invasive than surgery. Plus, biologics treatments are usually performed in an office setting without the need for sedation or significant downtime.

FACT: Using growth factors immediately following a knee injury has solid potential to stop or reduce cartilage degeneration and can effectively control pain.

FICTION: Orthobiologics is only effective in people over 50. While it is true that osteoarthritis of the knee tends to affect people most severely after age 50, orthobilogics holds plenty of promise for younger people, especially athletes trying to stave off post-traumatic osteoarthritis after a knee injury sustained at some point in their athletic career.

Some great news for humans is that medicine never takes a day off. With an aging Baby Boomer generation that is living a longer, more active life than the generations before it, this is the right time to consider ways to keep our populous going, using the least invasive methods first, when possible. New knee treatment options and possibilities are constantly emerging. The promise that orthobiologics holds is that it can help treat what's already ailing in the knee, yet it can also protect against what might befall it down the road. Anytime we can get multiple uses out of a non-invasive treatment option, I believe that's an option we should always strongly consider.

Sources:

https://www.fda.gov/about-fda/center-biologics-evaluation-and-research-cber/what-are-biologics-questions-and-answers

https://cartilage.org/patient/about-cartilage/cartilage-repair/growth-factors/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931137/

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