Ask Dr. Stulc: What Is Orthobiologics?

Can we use our body’s own repair abilities to heal damage to tissues? This is the question being explored in the emerging field of orthobiologics. Summit physiatrist Dr. Steven Stulc explains what orthobiologics is and how it can benefit patients.

The emergence of orthobiologics

“Orthobiologics research is promising, but it is still in its infancy,” Dr. Stulc explains. “Essentially, orthobiologics for orthopedics attempts to use our body’s own mechanisms for repair. These mechanisms concentrate healing agents such as growth factors, cytokines, and stem cells. You see these mechanisms at work when you cut your skin. Simply put, the injury triggers the repair mechanisms to act. Two weeks later, your cut has healed.”

Dr. Stulc specifies that concentrated platelet and stem cell injections are used to decrease pain and improve function, supporting the body’s ability to heal itself. “Using these treatments can help relieve pain so you can manage daily activities with better quality of life,” he points out. “For patients with arthritis, orthobiologics treatments delay our need to consider surgery. Sometimes, they manage pain so successfully that a patient can avoid surgery entirely.”

How orthobiologics works

Because this is an emerging area of medicine, physicians are still learning how regenerative therapies work in the body. “The most common understanding of stem cells is that they have the ability to turn directly into other cells, and that may be the case in the future as technology expands and regenerative science is better understood,” notes Dr. Stulc. “But current research suggests that these cells may act more like an orchestrator. That is, when they are delivered to an injured area, they recruit other substances to heal the injury. In the case of osteoarthritis, you can think of stem cells as working to return homeostasis, or a balance of good versus bad chemicals, to a joint. When you return homeostatic equilibrium to the joint, pain gets better because you have less inflammation and more healing.”

Two sources of orthobiologic treatments

“With orthobiologics, we take your body’s own innate healing factors, concentrate them, and then deliver the concentrate to the site of injury,” says Dr. Stulc. “Here at Summit, we use two methods to harvest and concentrate regenerative substances. Both methods are minimally invasive outpatient procedures.”

• Platelet-rich plasma (PRP) Platelet-rich plasma is obtained by drawing the patient’s own blood and then making a PRP preparation that concentrates the platelets. The concentrated solution is then precisely injected back into the injured area using guided imagery.
• Bone marrow aspirate concentrate (BMAC) Concentrated bone marrow contains adult stem cells and a host of other regenerative properties. It can be used in guided regenerative injections. “Stem cells can be obtained from several types of tissue,” notes Dr. Stulc. “At Summit, we use bone marrow stem cells. The marrow is extracted from the patient’s pelvic bone and concentrated to isolate stem cells and growth factors. This bone marrow aspirate concentrate is then injected into the injured area using guided imagery.”

Conditions that respond to orthobiologics

Research shows that several orthopedic conditions respond to regenerative medicine treatments.

• Spine Regenerative medicine is being used to treat degenerative discs and joints in the spine.
• Osteoarthritis In the peripheral body, regenerative medicine can be used to treat any large or small joint affected by osteoarthritis. These joints include the knee, hip, shoulder, elbow, or thumb joint.
• Soft tissues Regenerative medicine is also used to treat tendons, ligaments, and occasionally other soft tissues like muscle. “It can be helpful for tendons that aren’t healing properly,” says Dr. Stulc. “Examples include the patellar tendon in the knee, the Achilles tendon in the ankle, or the common extensor tendon, more commonly known as tennis elbow.”

Expertise with multiple imaging systems is a critical component of treatment

“As a physiatrist, Dr. Stulc trained to identify the source of pain and use a range of imaging systems to precisely place injections. Different imaging systems are used to guide injections targeted to different areas of the body. Physiatry training provides expertise with all of these imaging systems. Training with ultrasound guidance is required to treat sports injuries, peripheral joints, and tendons. Additional training in the use of a fluoroscopy machine is used to guide injections into discs. This range of imaging expertise provides the skills to use orthobiologics to accurately and precisely deliver injections to the injured area.

Managing patient expectations

“Orthobiologics and steroid injections are two treatment options that work very differently,” says Dr. Stulc. “I caution my patients not to expect regenerative injections to work like steroid injections. A steroid injection makes you feel better within a couple of days. But with orthobiologic treatments, you may actually have a little bit more pain during the first few days after treatment. That’s because the treated area is going through several regenerative phases. The first phase of healing is called the inflammatory phase. It is followed by a proliferative phase and a maturation phase. Depending upon the body part we are treating, you may not notice pain relief until between one and four months following the injection. That‘s important to know.”

“I think orthoiologics is a promising option for patients,” concludes Dr. Stulc. “Currently, it is a valuable treatment option for pain management. As research moves forward, we will become even more adept at harnessing the healing power of the body and putting it to work for our patients.”

Expert care

Summit’s team of experts provides orhtobiologics, an innovative treatment for those looking for an alternative to traditional treatments. They can treat arthritic joint pain, sports injuries, neck and back conditions—creating an environment to trigger tissue repair and healing.

Start your journey to better function and less pain. Visit our orthobiologics services hub and find your expert, request an appointment online, or call us at (651) 968–5201 to schedule a consultation.

More resources for you

• Read about pharmacologic treatment options for achy knees
• Do You Offer PRP Spine Treatments?
• Learn more about causes of osteoarthritis
• Watch the video: Meet Dr. Stulc

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