In Search of the Holy Grail-Part II
Driven by an unyielding desire to unlock the secrets of life itself, he spent his days immersed in ancient texts and his nights under the hum of modern machines, chasing the elusive promise of the Holy Grail of youth and longevity. Every discovery brought a surge of hope, yet left him craving more, convinced the answer was always just beyond reach. He ventured through dimly lit libraries, braved remote jungles for rare herbs, and surrounded himself with vials of elixirs that sparkled with the mystery of age-old alchemy. Each passing day left its mark, but he remained relentless, willing to sacrifice everything in his quest for eternal vitality—driven by the belief that immortality was not a myth but a prize for those who dared to seek it.
A modern chapter of this timeless quest is unfolding in the world of joint health and longevity science. As health consciousness rises, an active lifestyle has become the norm, with people of all ages and backgrounds—from weekend joggers and gym enthusiasts to seasoned athletes and professionals—all striving to keep moving. This pursuit transcends age, gender, and skill level, uniting everyone in a shared desire to stay agile, strong, and vibrant well into the future.
Orthobiologics are an emerging class of treatments that aim to harness the body's natural biological processes to repair, regenerate, and heal musculoskeletal tissues such as bone, muscle, cartilage, and tendons. Often described as “regenerative medicine,” these therapies are gaining traction in both general orthopedic practice and sports medicine, where their non-invasive nature attracts athletes and active individuals looking to recover faster and avoid surgery so they can keep active. The modern pursuit of the Holy Grail. Yet, it is surrounded by controversy, like anything new and promising “youthfulness” about whether it works or not.
Here we cut through the noise and provide evidence-backed information on the promise, the caveats, and what is ahead.
Current Landscape of Orthobiologic Treatments
Current orthobiologic treatments in practice and development include platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and bone marrow aspirate concentrate (BMAC), along with gene and exosome therapy. These therapies aim to promote tissue healing by leveraging growth factors, proteins, and cellular elements inherent in the body.
Platelet-Rich Plasma (PRP): PRP, derived from the patient’s own blood, is concentrated with healing growth factors that can speed up tissue repair and reduce inflammation. It’s been used to treat tendon injuries, osteoarthritis, and muscle tears, offering quick, minimally invasive relief with promising short- to mid-term results. However, it's expensive and not widely accessible.
Orthopedic associations view PRP as a promising yet experimental option, recommending it for conditions like tendinopathy and mild osteoarthritis when other treatments fail. They emphasize the need for more research and advise doctors to discuss PRP's limitations with patients.
Mesenchymal Stem Cells (MSCs): MSCs come from sources like bone marrow or fat and can become different tissue types, such as cartilage, bone, and muscle. They’re promising for treating injuries like osteoarthritis (OA) or severe joint damage
Orthopedic groups are cautiously optimistic about MSC therapy’s potential but stress that more quality research is needed to confirm its safety, effectiveness, and long-term results, Regulatory oversight is also crucial for these treatments.
Bone Marrow Aspirate Concentrate (BMAC): BMAC is a process where bone marrow, usually taken from the pelvis, is concentrated to provide a high dose of stem cells directly to an injury. This method aims to boost healing and tissue repair, especially for tendon and cartilage injuries.
While BMAC shows potential, orthopedic associations recommend caution, suggesting it only be used in clinical trials or specific cases. Patients should be informed that BMAC is still considered experimental until more solid evidence supports its effectiveness.
Gene Therapy and Exosome Therapies: Gene therapy aims to repair damaged tissue by directly altering genetic material, while exosomes—tiny packets released by cells—help send healing signals. Both methods are being explored to boost existing treatments, with hopes of speeding recovery and reducing long-term issues like post-traumatic osteoarthritis (PTOA).
However, gene therapy is not recommended for regular use yet due to limited data and safety concerns, including possible immune responses and unintended genetic changes. The American Academy of Orthopedic Surgeons (AAOS) calls for more research to assess long-term safety and effectiveness.
Exosome therapy is also considered experimental. The AAOS advises against its general use, citing the need for better quality control and concerns about immune reactions due to insufficient large-scale studies.
Addressing the Challenges: Variability, Standardization, Accessibility and Cost
While orthobiologics show promise, their effectiveness varies due to differences in how treatments are prepared and formulated. Without standardized preparation and strong regulatory oversight, results can be inconsistent. Also, potential risks like immune reactions with gene or exosome therapies highlight the need for stricter development protocols. These treatments are also expensive and lack solid clinical proof, so most insurance companies won’t cover them, limiting their wider use.
The Future of Orthobiologics in Sports Medicine
Looking forward, orthobiologics are set to play an increasingly essential role in early oa, sports medicine and injury recovery. These innovative therapies emphasize precision medicine by customizing treatments to each individual’s unique cellular and molecular profile, potentially enhancing both healing outcomes and athletic performance.
Clinical Application: Orthobiologics and Scar Tissue
Orthobiologics show promise in treating conditions like arthrofibrosis, an abnormal build-up of scar tissue in joints that limits mobility and can lead to post-traumatic osteoarthritis (PTOA). Common after sports injuries or surgeries like ACL reconstruction and joint replacements, arthrofibrosis causes stiffness, pain, and restricted movement, often impacting athletic performance. This excess scar tissue triggers inflammation and stress on joint cartilage, accelerating degeneration and potentially leading to PTOA.
Temple ORTHOBiologics’ Solution for Arthrofibrosis
One of the newest tools in early development by Temple ORTHOBiologics is TX-33.
Dr. Riley J Williams III, a co-founder and an attending orthopedic surgeon at the Hospital for Special Surgery says, “TX-33 is a game changer.” Dr. Williams, team physician to several professional sports teams knows a bit about knee injuries and athletes. He also knows that many active people rush their recovery and increase the possibility of re-injury or a new one. “They want that feeling again of I’m back!” as soon as possible.
TX-33 is a unique combination of advanced biomaterials and a derivative of a compound used for years by athletes for muscle recovery and repair. When injected into the knee joint, after injury or surgery, early mechanistic and clinical studies (5, 6) suggest it works by promoting healthy healing. Combined with advanced rehabilitation techniques and a proper diet and lifestyle, it could help accelerate recovery and support a quicker return to play, safely.
Dr. Vinod Dasa, Irvin Cahen Chair of Orthopedic Research, Professor, Innovator, Surgeon and LInkedin Influencer, “Orthobiologics with a clearly defined mechanism of action and value proposition are needed because most of what we have is a black box in what they do and how they work. TX-33, has the potential to not only give us the clinical benefit of reducing fibrosis but also give us the why and how”.
Conclusion: The Future of Sports Medicine
Orthobiologics are transforming sports medicine by offering promising, less invasive treatments for various injuries, reducing recovery time and the need for surgery. From addressing osteoarthritis and tendon issues to treating complex cases like scar tissue and arthrofibrosis, these therapies support joint stability, muscle strength, and tissue health while reducing inflammation. Research shows that early, targeted interventions help joints heal fully, lowering the risk of re-injury and long-term complications like post-traumatic osteoarthritis (PTOA).
However, as with any medical treatment, it’s essential to consult a healthcare professional to determine whether orthobiologics are suitable for your condition. While the science is promising, more research is needed to fully understand the long-term effectiveness of these treatments and ensure consistent results.
Subscribe to this blog to receive continued evidence backed information on the world of sports medicine, orthobiologics, peak performance and related subject matters. Temple Orthobiologics’ world class team of medical, scientific, athletic trainers and athletes help us provide a comprehensive view which we share with you.
Medical Disclaimer: The information provided in this blog is for educational purposes only and should not be considered medical advice. Always consult a healthcare professional before making decisions about your treatment options. Orthobiologic therapies, while promising, may not be suitable for everyone and should be discussed with a qualified practitioner.
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5. Robertson LM, Fletcher NM, Diamond MP, Saed GM. Evitar (l-Alanyl-l-Glutamine) Regulates Key Signaling Molecules in the Pathogenesis of Postoperative Tissue Fibrosis. Reprod Sci. 2019;26(6):724-33. Epub 2018/09/05. doi: 10.1177/1933719118789511. PubMed PMID: 30185141.
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