Orthobiologics: A Track Record of Success
One question that often comes up in discussions about orthobiologic treatments is: what is the track record of these treatments? Are they a new thing? Are they experimental?
The answer is that while it may seem as though orthobiologic treatments are new, they’ve actually been around for quite a while. Treatments like platelet-rich-plasma (PRP) injections have been used in clinical practices for decades, where they have proved their effectiveness in treating a range of musculoskeletal conditions.
As I’ve discussed in other posts, PRP is a substance that’s derived from a patient’s own blood. It contains a high concentration of platelets, which release growth factors that promote tissue healing, reduce inflammation, and enhance cell proliferation. As demand for non-surgical and minimally invasive therapies as grown in recent years, PRP has emerged as a promising option. But let’s take a look at some of the research.
PRP for Osteoarthritis
One of the most studied applications of PRP is in the management of knee osteoarthritis (OA). Several randomized controlled trials (RCTs) and meta-analyses support its effectiveness.
For example, a 2021 meta-analysis in The American Journal of Sports Medicine found that PRP injections provided significant pain relief and functional improvement in knee OA compared to both hyaluronic acid and placebo treatments.
A further study in Arthroscopy: The Journal of Arthroscopic & Related Surgery in 2020 demonstrated that PRP injections delivered greater long-term pain reduction and functional improvement compared to corticosteroids.
Also, a systematic review in The Journal of Bone and Joint Surgery in 2022 indicated that PRP may delay the need for knee replacement surgery in patients with mild-to-moderate OA.
PRP for Tendon and Ligament Injuries
Tendon and ligament injuries are notoriously slow to heal due to limited blood supply. Even in these cases, PRP has shown promise in enhancing recovery.
A 2020 study in JAMA reported that PRP injections improved pain and function in tennis elbow (chronic lateral epicondylitis), outperforming placebo treatments. Research in The American Journal of Sports Medicine in 2019 further found that PRP accelerated healing in Achilles tendinitis, delivering better collagen organization and improved structural integrity.
Further, a randomized controlled trial in The Orthopaedic Journal of Sports Medicine in 2021 demonstrated that PRP was beneficial in treating partial anterior cruciate ligament (ACL) tears, reducing recovery time and improving ligament strength.
PRP for Muscle Injuries
Athletes and other active individuals frequently seek PRP therapies when they experience muscle strains and tears. A 2021 British Journal of Sports Medicine study found that PRP injections in hamstring injuries reduced return-to-play time compared to conventional rehabilitation.
A systematic review in Sports Medicine in 2022 concluded that PRP therapies improved muscle regeneration in acute injuries (but also noted some variability in outcomes depending on the PRP preparation techniques that were used). Some evidence also suggests PRP may reduce re-injury rates, as seen in a 2023 Clinical Journal of Sport Medicine trial that examined recurrent quadriceps strains.
PRP Compared to Other Treatments
When compared to traditional treatments like corticosteroids and hyaluronic acid, PRP shows superior long-term outcomes. Unlike corticosteroids which provide short-term symptom relief but may weaken tissue over time, PRP supports both tissue healing and regeneration.
PRP frequently provides longer-lasting benefits than hyaluronic acid in knee osteoarthritis in head-to-head trials. Compared to physical therapy alone, PRP may enhance recovery speed in certain musculoskeletal conditions, though it’s often used in conjunction with rehabilitation programs.
All of which is to say that the evidence is in: clinical studies clearly support the effectiveness orthobiologic treatments when it comes to promoting healing and reducing pain. And in fact they often outperform traditional treatments, particularly in long-term outcomes.
Research will of course continue, however PRP will almost certainly play an increasingly important role in regenerative medicine, offering patients an alternative to surgery and chronic pain management. For more on orthobiologic treatments and their effects on specific conditions, look at my other posts!