As the treatment of musculoskeletal disease has evolved, significant advancements have been made in the use of biologic adjuncts. Breakthroughs in basic science have provided evidence that the use of biologic and regenerative applications can aid in the treatment of many musculoskeletal disorders. These innovative treatments have been studied in the non-operative treatment of many conditions (from sports medicine injuries to arthritis) and to enhance outcomes in orthopedic surgical procedures.
What are Biologic Treatments?
The current biologic treatments offered include platelet rich plasma (PRP) injections and bone marrow aspirate concentrate (BMAC) stem cell therapy. While there are numerous studies looking at the effectiveness of these procedures, they remain a cutting edge technology. Research is underway to help better understand the potential of the treatments.
What is Platelet Rich Plasma (PRP) Therapy?
Human blood is mainly composed of a liquid called plasma. Other components include red blood cells, white blood cells, and platelets. Platelets contain hundreds of proteins known as growth factors that can assist with healing injuries. PRP combines plasma with a high concentration of platelets. The concentration of growth factors in PRP can be 5 to 10 times greater than what is typically found in blood. Studies have shown PRP therapy can help increase the healing process of many acute and chronic injuries
To obtain PRP, blood is drawn from the patient. Then, the blood is spun in a centrifuge, which is a machine that uses high speeds to separate the main components of blood. The platelets are extracted with the plasma layer, creating platelet rich plasma. The PRP is then injected into the injured area to help promote healing.
What is Bone Marrow Aspirate Concentrate (BMAC) Treatment?
Bone marrow aspirate concentrate (BMAC) is prepared from a patient’s bone marrow. BMAC contains growth factors similar to PRP plus a concentration of stem cells, that further contribute to the healing process. Stem cells can help enhance bone healing, tendon healing, cartilage repair
The BMAC procedure is performed in the clinic with local anesthetic (numbing medication). The patient is not required to go to sleep or have general anesthesia, however some relaxing medication may be used. Bone marrow is extracted from the posterior pelvis using X-ray guidance to confirm appropriate position. The sample of bone marrow is spun in a centrifuge followed by extensive preparation to separate viable cells. A high concentration of stem cells is produced. This concentration of BMAC and plasma is then injected back into the injured site with the use of X-ray or ultrasound guidance when required.
What Conditions Do Regenerative Therapies Treat?
While research continues to help evaluate the effectiveness of regenerative therapies, there are a number of conditions that research has shown improvements in healing outcomes. Regenerative therapies can help treat:
- Chronic tendon injuries
- Acute Ligament and Muscle Injuries
- Joint Arthritis and Chondral Damage
- Bone Fractures
Regenerative therapies are also being used during common orthopedic surgeries. In this setting, regenerative medicine is used to help with tissue healing at the surgical site.
How are PRP and BMAC Treatments Administered?
Both procedures are performed at the South Asheville/Arden office (2585 Hendersonville Rd.) and patients will go home the same day. In certain cases, the use of x-ray (fluoroscopy) or ultrasound are used by Dr. Boykin. The majority of insurance carriers have yet to cover these procedures. Patients should check with their specific insurance, and our team is happy to assist with this and discuss the costs of PRP or BMAC.
Are Biologic Treatments Right for Me?
Orthopedic and sports medicine specialist, Dr. Robert Boykin remains on the forefront of these new biologic technologies. Dr. Boykin is available to discuss the current data with patients and the options for biologic adjuncts to treat their condition. While these treatments hold much promise, the data for many conditions is still in its infancy. We encourage patients to also explore the growing body of literature surrounding these procedures.
This paper, co-authored by Dr. Boykin, explores the use of biologic and regenerative treatments in orthopedic surgery: Regenerative Treatments to Enhance Orthopedic Surgical Outcome