PRP can relieve pain caused by knee arthritis
Similarly , not all tendon injuries have improved with orthobiologics . “ We haven ’ t seen any great benefit for Achilles tendinitis , so we don ’ t use either PRP or stem cells to treat it ,” he said .
The road ahead for orthobiologics More research is required to strengthen the evidence backing up current regenerative treatments and expand the pool of conditions that can be treated with them .
“ There are many people who are still sceptical about orthobiologics and for good reasons ,” acknowledged Dr Shapiro . “ We test vaccines on thousands of patients and these orthobiologics sometimes have only be tested on 25 or 50 patients — that ’ s not good enough evidence .”
Putting together data from multiple studies , he added , will make a stronger case for the use of orthobiologics , thus allowing them to gain more traction .
One successful example is the use of PRP during rotator cuff surgery . “ Initially , all the studies were negative and it looked like it didn ’ t work , and it was only after researchers were able to combine larger numbers of patients , up to a thousand , that allowed the statisticians to determine that there was an actual benefit ,” he said .
What this means is that we ’ re going to need specific studies to determine which orthopaedic condition is potentially amenable to which orthobiologic treatment before jumping to conclusions about what works against certain diseases .
“ We have a stem cell study for shoulder arthritis because most of the research has gone into looking at knee arthritis , and then you just assume that everything that works for knee arthritis also works for the hip and the shoulder , but that ’ s not actually the case ,” explained Dr Shapiro . “ The orthopaedic community needs to conduct the same clinical trials in the shoulder , the hip , the wrist , and the ankle as we do in the knee , so we ’ re working on that for the shoulder .”
Another goal pursued by many researchers is to use orthobiologics to regrow knee cartilage , a breakthrough that could potentially help millions of people improve their mobility , decrease pain , and avoid knee replacement procedures .
One study at the Mayo Clinic looks promising , said Dr Shapiro , with early results hinting that patients ’ stem cells that have been expanded in the lab ( a technique not currently used in the clinic ) can plug small defects in knee cartilage .
If successful , this approach could treat people who have signs of early cartilage degeneration before they reach a point where the knee joint is compromised and the only option is to replace it through surgery . Dr Shapiro believes this prospect is not far-fetched . “ This trial just goes to show you that the treatments we ’ re using right now are our first effort at using cells to cure orthopaedic disease , but we anticipate , with better research , more trials , and novel therapies , we ’ ll be able to do even better .” n
Another goal pursued by many researchers is to use orthobiologics to regrow knee cartilage , a breakthrough that could potentially help millions of people improve their mobility , decrease pain , and avoid knee replacement procedures
GlobalHealthAsiaPacific . com OCTOBER 2021
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