Rationale for the Use of Orthobiologics in Sports Medicine

Abstract

Orthobiologic approaches can be defined as strategies that seek to enhance musculoskeletal tissue healing and regeneration by modulating the biologic environment. Approaches include growth factors, autologous and allogeneic blood products, scaffolds, and cell therapies that can be used in isolation or to augment surgical procedures. Orthobiologic techniques to treat sports injuries have gained considerable interest over recent years. The potential for these approaches to restore function and accelerate recovery using methods that are minimally invasive or to augment current surgical techniques is an attractive prospect for both patients and surgeons. All orthobiologic approaches seek to harness intrinsic processes of tissue repair, and as such, there is good rationale for their use to augment the natural healing response. Promising in vitro data, a lack of regulatory consensus and a drive for meeting the public demand for novel therapies have fuelled a rapid increase in the use of biologic approaches over the past decade. Despite considerable legitimate research effort, there is increasing concern about unregulated and poorly characterized therapies being offered by some providers. This article outlines the need and rationale for using biologic approaches in orthopaedic sports medicine and outlines a stepwise approach for the clinical application of these emerging therapies to appropriately match formulations and indications.