Orthobiology regenerative medicine: what it is and how it works

By exploiting the ability of cells to regenerate it is possible to combat various orthopedic pathologies. Professor Momoli describes the most advanced methods

Roberto De Filippis

One of the most interesting branches of regenerative medicine it’s orthobiology. This term indicates some methods that exploit the regenerative capabilities of the cells of the human body with the aim of stimulate the regrowth of some tissues and of reduce inflammation. In the orthopedic field, thanks to orthobiology techniques we have entered a new era.

Orthobiology: what it is and what are the most used treatments

The first generation of orthobiological treatments is represented by hyaluronic acid infiltrations. In orthopedics it is used above all to prevent and treat arthrosis. In fact, this substance increasing the elasticity and viscosity of the cartilage, slows down the degenerative process that characterizes this pathology. A more advanced orthobiological treatment than hyaluronic acid infiltrations is Prpwhile the last frontier in this area is represented by the use of mesenchymal cells. Prp (an acronym for “platelet-rich plasma”) involves the collection, from the same patient, of 20-30 cc of blood, which are then placed in a centrifuge, so as to make the red blood cells and white blood cells sink to the bottom , obtaining a platelet concentrate, which are rich in growth factors. Not only is the injection of Prp into the joint eases the pain, but also has positive effects on the structure of the cartilage. “Many scientific studies highlight the effectiveness of treatment with Prp, provided however that certain conditions are respected, starting from the quantity of platelets that are injected” underlines the Professor Alberto Momoli, director of the Orthopedics and Traumatology Unit of the San Bortolo Hospital in Vicenza and president of Siot (Italian Society of Orthopedics and Traumatology). This treatment is indicated in cases of osteoarthritis in non-advanced stages (not beyond the second stage) and tendonitis.

Treatment with mesenchymal cells

Even more advanced is the orthobiological treatment which involves the use of mesenchymal cells, which are always taken from the same patient. To obtain them you need one liposuction, which is often carried out at the abdomen. The collected adipose tissue is then subjected to a specific process, which increases the regenerative capacity of the mesenchymal cells contained therein. Once injected into the joint, these cells they stimulate cartilage and reproduce. This is a slightly more complex procedure than that required by PRP treatment, but it also takes place in outpatient regime. “In both cases it is important to turn to certified centers with high quality standards” advises Professor Momoli. When used on people with osteoarthritis, the mesenchymal cell-based treatment is also useful in case of tendonitis, it is very effective on the knee and a little less on the hip. However, it must be borne in mind that this care it is only capable of slowing down the arthritic processbut not to make it regress.

Orthobiology: why it is used only in selected cases

In athletes, both professional and amateur, who suffer from tendonitis, the use of Prp-based treatment is very common. In addition to being simple, in fact, it guarantees good results in reducing both the ache both of theinflammation. However, they may be necessary for a clear improvement in the situation more infiltrations, both when Prp is used and when mesenchymal cells are used. “The choice of one or the other method should be based on the characteristics of the individual patient and the problem he is afflicted by” specifies Professor Momoli. In case of arthrosis, both treatments are indicated when the disease is first or second degree; when it is third degree, only the option of the technique that involves the use of mesenchymal cells can be evaluated, while if it is fourth degree there are no alternatives to surgery. Scientific studies are currently underway to evaluate the effectiveness of treatment with mesenchymal cells on muscle injuries and on skin and bone callus regeneration following fractures.