Orthobiologics are a hot topic among orthopedic surgeons who treat professional athletes. Generated from natural substances in the body and often formulated into high concentration treatments, substances like platelet-rich plasma, bone marrow injections and other stem cell treatments and bone grafts may speed up the healing process and are becoming more frequently used therapies for many of the injuries discussed above.
Platelet Rich Plasma (PRP)
PRP injections have gained favor among NFL athletes in recent years looking for quicker healing of a variety of injuries. Platelets are cell fragments carried in the blood that help form clots, but also contain growth factors that promote healing of connective and vascular tissue. When a blood sample is spun and separated, a plasma concentrate that contains 90% platelets can be generated – platelet-rich plasma.
PRP injections remain controversial in the orthopedic community. They have been used for tendonitis and muscle strains and to assist in fracture healing and ligament repairs. Some studies report dramatic improvements and others no improvement at all. There is some concern that some growth factors may worsen outcomes by contributing to scar tissue, particularly when used to aid muscle healing. Expect to hear more players being treated with PRP, with much more research to standardize the amounts and types of growth factors included in each treatment and determine which injuries PRP is most successful on the horizon.
Bone Marrow Aspirate / Stem Cell Injections
Stem cells are immature cells with the potential to become many different types of cells based on where they are in the body and how they’re influenced by their environment. When they arrive at an injury site naturally or are introduced in higher concentrations by injection, they can develop into new bone, muscle, ligament or cartilage cells.
Stem cells can be removed from a person’s bone marrow (usually in the hip) or harvested by donation. The small amount of stem cells in the marrow sample must be separated, grown and expanded in the laboratory, a process which can take as long as three weeks, before they are injected at the injury site. Like PRP treatments, the use of bone marrow treatments (stem cell therapies and bone matrix) is a relatively new treatment, with more studies describing its effectiveness and success expected soon.
Categories: Navigating Injury Report Series
Fascinating stuff. When you comment, “Expect to hear more players being treated with PRP, with much more research to standardize the amounts and types of growth factors included in each treatment and determine which injuries PRP is most successful on the horizon,” I can’t help but think these players are essentially willing lab rats. We’re clearly not talking the Tuskeegee experiments or Henrietta Lacks, but these guys are willing to try some cutting edge stuff to get back on the field, that’s for sure.
Dr. Bramel, I would love to hear more about this area of sports-science. Also, if it isn’t outside of your comfort-zone / expertise could you please comment on human growth hormone? I understand that consensus media opinion is that the use of it is bad for sports. But if you did cover this topic could you touch on what actually happens physiologically and what are the side-effects? Bottom line is I do not understand why it is illegal to use. It sounds like it only helps the body remain strong and young. What am I missing?