Orthobiologics - Injections
What are Orthobiologics?
Orthobiologics are natural substances such as cells, tissue, blood components and growth factors that are harnessed to aid in the treatment of orthopedic injuries or conditions. They may be used to replace lost tissue, stimulate regeneration and healing, reduce pain and inflammation and improve joint function.
Orthobiologics may be obtained from your own body or from a donor. They may be administered in the form of injections or may require a surgical procedure. They may be used alone as conservative treatment or following orthopedic surgery to enhance results.
What are the Conditions treated by Orthobiologics?
Orthobiologics can be used to treat:
- Articular cartilage injuries
- Early osteoarthritis
- Ligament injuries
- Tendon injuries
When are Orthobiologics recommended?
Orthobiologics are recommended when rest, medications and physical therapy do not relieve symptoms and joint replacement surgery is not indicated. It may also be recommended following spine surgery.
Types of Orthobiologics
The different types of orthobiologics include:
- PRP Therapy
What is PRP Therapy?
Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body’s healing process. Platelet-rich plasma or PRP is a high concentration of platelets and plasma. A normal blood specimen contains only 6% platelets, while platelet-rich plasma contains 94% platelets and 5 to 10 times the concentration of growth factors found in normal blood, thus providing greater healing properties.
What are the Indications for PRP?
PRP is a relatively new treatment method for several orthopedic conditions such as muscle, ligament, and tendon injuries, arthritis and fractures. PRP injections can help alleviate painful symptoms, promote faster healing and delay joint replacement surgeries.
How is Platelet Rich Plasma Therapy Performed?
Your doctor will first draw about 10 ccs of blood from the large vein in your elbow. The blood is then spun in a centrifuge machine for about 10 to 15 minutes to separate the platelets from the remaining blood components.
The injured part of your body is then anesthetized with a local anesthetic. The platelet-rich portion of your blood is then injected into the affected area. In some cases, your doctor may use ultrasound guidance for proper needle placement.
What is the Post-Procedural Care for PRP?
- It is normal to feel some discomfort at the injection site for a few days after your procedure.
- You will be prescribed pain medications as needed by your doctor.
- You may use cold compresses to alleviate your symptoms.
- You will be instructed to stop any anti-inflammatory medications.
- You may resume your normal activities but should avoid any strenuous activities such as heavy lifting or exercises.
What are the Risks and complications of PRP?
There are minimal risks associated with PRP injections. Some of the potential risks include
- Increased pain at the injection site
- Damage to adjacent nerves or tissues
- Formation of scar tissue
- Calcification at the injection site
What is Viscosupplementation?
Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows smooth movement of the cartilage covered articulating surfaces of the joint.
Indications of Viscosupplementation
Hyaluronic Acid Injections is one of the most commonly used hyaluronan preparations. It is indicated in the management of shoulder, knee, hip or ankle osteoarthritis that has not responded to non-surgical treatment options such as pain medications, physical therapy and corticosteroid injections.
Hyaluronic Acid Injections provides symptomatic relief and delays the need for surgery. It is injected directly into the joint to replenish the diminished synovial fluid, thereby enhancing its lubricating properties. A single dose or a total of three separate doses of Hyaluronic Acid Injections, over several weeks, may be required for optimum benefit.
How does Viscosupplementation Work?
Hyaluronic Acid Injections not only supplements the hyaluronan in the joint but also stimulates the production of hyaluronan in the treated knee. This provides gradual symptomatic relief over the course of the injections. This effect may last for several months.
Post-procedural Care Following Viscosupplementation
Ice packs and an analgesic may be used, if required, to ease the discomfort. Any strenuous activity such as jogging or tennis should be completely avoided for 48 hours to a week after the injection and should be resumed only after consultation with your doctor.
Risks of Viscosupplementation
You may experience mild pain, swelling, warmth and redness at the injection site for up to 48 hours following a Hyaluronic Acid Injections injection. Headache and joint stiffness may also occur in some cases.
Immediately consult your doctor if you develop fever or the pain and swelling fail to resolve after 48 hours following the injection.
Amniotic tissue products such as amniotic membrane and amniotic fluid can reduce inflammation and promote healing in tissues due to their cellular content and presence of hyaluronic acid. Amniotic tissues support the fetus in the womb. They are obtained from a consenting healthy donor following an elective cesarean section delivery. These products are carefully screened before use. They are available as injections or patches.