Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2024; 15(10): 908-917
Published online Oct 18, 2024. doi: 10.5312/wjo.v15.i10.908
Evidence-based orthobiologic practice: Current evidence review and future directions
Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Sangeetha Balaji, Sathish Muthu
Madhan Jeyaraman, Naveen Jeyaraman, Department of Orthopedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Madhan Jeyaraman, Sathish Muthu, Department of Research Methods, Orthopedic Research Group, Coimbatore 641045, Tamil Nadu, India
Swaminathan Ramasubramanian, Sangeetha Balaji, Department of Orthopedic, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nadu, India
Sathish Muthu, Department of Orthopedics, Government Medical College and Hospital, Karur 639004, Tamil Nadu, India
Sathish Muthu, Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore 641021, Tamil Nadu, India
Co-first authors: Madhan Jeyaraman and Naveen Jeyaraman.
Author contributions: Jeyaraman M conceptualized the manuscript; Jeyaraman N, Ramasubramanian S and Balaji S performed data analysis and wrote the manuscript; Muthu S performed image analysis. All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: Authors declare no conflicts of interest in publishing the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Madhan Jeyaraman, MS, PhD, Assistant Professor, Research Associate, Department of Orthopedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com
Received: July 16, 2024
Revised: August 31, 2024
Accepted: September 11, 2024
Published online: October 18, 2024
Processing time: 87 Days and 3.5 Hours
Abstract

The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic. These biologically derived therapies, including platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, stromal vascular fraction (SVF), and autologous chondrocyte implantation, are gaining traction for their potential to enhance the body's natural healing processes. They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions. Current evidence suggests significant benefits of orthobiologics in treating conditions like osteoarthritis, tendon injuries, and spinal disorders, yet inconsistencies in treatment protocols and outcomes persist. The global market for orthobiologics is projected to grow substantially, driven by advancements in biologic therapies such as adipose-derived stem cells and SVF, and the demand for minimally invasive treatments. Despite their promise, regulatory and ethical challenges, as well as the need for high-quality, standardized research, remain significant obstacles. Future directions in the field include advancements in delivery systems, personalized medicine approaches, and the exploration of novel sources like induced pluripotent stem cells, aiming for more targeted and effective treatments. Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.

Keywords: Orthobiologics; Platelet-rich plasma; Stem cells; Musculoskeletal regeneration; Regenerative medicine; Evidence-based medicine

Core Tip: Orthobiologics, including platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate, stromal vascular fraction, and autologous chondrocyte implantation, show significant potential in enhancing musculoskeletal healing and reducing the need for invasive surgeries. Despite their growing popularity, inconsistencies in treatment protocols and evidence levels highlight the need for standardized, high-quality research. Future advancements in delivery systems, personalized medicine, and novel cell sources may further optimize their efficacy and safety.