Orthobiologics / Stem Cells

Orthobiologics are substances that orthopaedic surgeons use to help injuries heal more quickly. They are used to improve the healing of broken bones and injured muscles, tendons, and ligaments. These products are made from substances that are naturally found in your body. When they are used in higher concentrations, they may help speed up the healing process.

Healing Process

When you injure a bone, muscle, or tendon, there is bleeding into the injured area. This bleeding is the foundation for the healing response. It provides a way for healing factors to reach the injury site.

In addition to bleeding, there are three factors necessary for healing. All three are orthobiologic substances. They include:

This can be thought of as the house in which the cells live and where they will thrive and eventually make bone, tendon, or ligament. Matrix material is conductive. This means it can form the building blocks that help fill bone gaps.
Growth factors.These are the many different kinds of proteins necessary for cells to work during the healing process. Some proteins help speed up the healing process, while others help to control it or slow it down. These elements are much like the vitamins that we take every day to try to improve our health and body function.
Stem cells.These are special cells in your body that can turn into other types of cells. During the healing process, stem cells are called to the area of your body that needs repair. Factors in the area influence the stem cells to become repair cells. Note that the same stem cell that repairs bone can also repair a tendon or ligament.

Stem Cells

Of all the types of cells, stem cells have the greatest potential for promoting healing. As discussed above, stem cells are immature cells that are influenced by their surroundings. When brought to an injury site, a stem cell can develop into the kind of cell needed to help in healing - bone, muscle, ligament, and cartilage.

Stem cells can turn into muscle, tendon, bone, or cartilage.

Because of the healing capabilities of stem cells, doctors have developed ways to bring stem cells to an injury site faster and in greater numbers. The first step in this process is to retrieve the stem cells. This can be done by harvesting them from the patient, or through a stem cell donor program.

Stem Cell Harvesting

There are many sources of stem cells in the human body. The most important source is bone marrow. Bone marrow is located in the centers of long bones, such as the bones in your arms, forearms, thighs, and legs. The pelvic bone contains the highest concentration of stem cells. Therefore, the bone marrow in your pelvic bone is the most common source for harvesting stem cells.

The doctor draws the stem cells out of the bone marrow with a needle, in a similar way that blood is drawn from your arm for tests. An orthopaedic surgeon then inserts this large supply of stem cells into the injury site. This eliminates the time it would take for the stem cells to reach the injury on their own and delivers them in a higher concentration, which speeds the healing process.

Stem Cell Donation

Orthopaedic surgeons can also use donor stem cells to promote healing. In much the same way that blood transfusions help millions of patients each year, stem cells taken from donors after they pass away help millions of orthopaedic patients. When these cells are harvested, they are treated so that they will not create an immune or allergic reaction in the patient.

Future of Orthobiologics

Each year, there are many new developments in the area of orthobiologics. For example, researchers are currently working on a "bone glue" that would not only fix fractured bones together, but also provide substances to aid the healing process. At this time, bone glues have not been proven effective, and there are none currently available. They have excellent potential in the future, however.

Today, doctors have many more options to help the musculoskeletal system heal than they had 15 years ago when most orthobiologics were not available. The goal is to get patients back to the way they were prior to their injuries.