Regenerative medicine (sometimes referred to as “biologics” or “orthobiologic regenerative medicine” in orthopedics) broadly refers to natural products that are harvested and used to supplement healing. There is great interest in this form of medicine in orthopedics and sports medicine, notably as it relates to sports performance and the treatment of sports injuries.
Regenerative medicine/biologics entails the use of growth factors, cells or tissue. Researchers have performed hundreds of clinical trials evaluating mesenchymal stem cells (MSCs) and there have been well over 100 trials evaluating platelet-rich plasma therapy (PRP). While many studies show good outcomes for regenerative medicine in orthopedics and sports medicine, this is still an emerging area of medicine where evidence should support its usage. That said, the future of regenerative medicine is bright and its use and indications are bound to expand with continued research.
Dr. Cunningham is excited about regenerative medicine and how it might help his patients recover faster and get back to the sports and activities that they enjoy sooner. The two primary forms of regenerative medicine/biologics used in sports medicine and orthopedics and practiced by Dr. Cunningham are:
Platelet-Rich Plasma Therapy (PRP) & Orthopedics
With the platelet-rich plasma procedure (PRP), blood is drawn from a patient, the blood is centrifuged, and the platelets are isolated and concentrated. These platelets are then injected into an arthritic joint or onto an inflamed tendon. The growth factors in the platelets are released at these injury sites and there is evidence that the growth factors can attract mesenchymal stem cells (MSCs) and other types of cells. In turn, the MSCs stimulate local protein production that can quicken healing and decrease inflammation.
Stem Cells & Orthopedics
Stem cells have four defining qualities: 1) they can reproduce; 2) they can differentiate into different cell types; 3) they can mobilize; and, 4) they can turn on or off other cells in their local environment. Stem cell therapy is primarily used in orthopedic and sports medicine as an enhancement to surgery. Dr. Cunningham harvests patients bone marrow that contain stem cells and then these are injected at the site of a surgical repair. In some cases, the use of stem cells in surgery can increase healing and improve outcomes. Stem cells can also be used in the clinic setting as a standalone procedure to treat some conditions and possibly avoid or delay surgery.