Regenerative Orthopedics and Orthobiology

Regenerative medicine represents an important step forward in the treatment of degenerative diseases, which until now were considered incurable.
The approach of this innovative branch of medicine concerns not only the symptoms of diseases, but aims to cure or reconstruct the tissues, cells and organs damaged by the pathology.
To do this, regenerative medicine makes use of molecular biology and advanced knowledge of cell lines, useful for organ regeneration:

By exploiting this knowledge, specialists in this discipline are able to effectively treat tissues and organs that would otherwise be impossible to repair with traditional therapies.
One of the most amazing features of Regenerative Medicine is its ability to stimulate our body’s innate abilities to repair and regenerate damaged tissues, cells and organs.
In this way, our organism becomes an active participant in the healing process, capable of significantly contributing to the treatment of illnesses and pathologies.
Furthermore, regenerative medicine represents great hope for the treatment of degenerative diseases related to ageing.
Thanks to its ability to replace and rebuild damaged tissues and organs, it is possible to imagine a future in which the quality of life of people affected by these pathologies can significantly improve.
Regenerative medicine opens new paths in the fight against diseases and pathologies, representing a real revolution in human health care.

In orthopaedics, regenerative medicine deals with treating degenerative pathologies of connective tissues, such as:

The revolution in this branch of orthopedic medicine is to use the patient’s cells to treat the degenerative diseases they suffer from, avoiding allergies, rejections and complications.

In this in-depth analysis we will talk about the opportunities that regenerative medicine has opened up with respect to orthopedic pathologies.
Among these we can list:

Let’s understand better what pathologies we are dealing with

Knee osteoarthritis is a degenerative disease that occurs when the cartilage lining the knee thins or deteriorates, causing:

The causes of this degenerative pathology are various and depend on the age and habits of the person affected.
Among the main causes we can list:

Knee osteoarthritis is a pathology that cannot be cured, and this is where regenerative medicine and its innovative treatments come into play.

First of all, we must distinguish between the various arthritic pathologies that affect the hip:

Hip arthrosis is also a degenerative joint disease in which the cartilage that lines the head of the femur and the acetabular cavity is affected. The symptoms are:

Depending on the severity of the disease, the treatments are different and surgery is also included to improve the patient’s quality of life.
But before resorting to surgery, regenerative medicine offers other possibilities to slow the progress of the disease.
In any case, it is necessary to understand whether bone lesions or other associated pathologies are present.

When we talk about tendon and ligament injuries, we mean damage to the connective tissues that connect bones and allow the body to move. The damage to the muscle is generally linked to domestic or sports work trauma or functional overload.
Tendons are large bands of connective tissue that connect the ends of muscles to bones. Ligaments, on the other hand, are fibrous cords, always made up of connective tissue, which wrap around the joints and bind them together. They can also connect one bone to another, as in the case of the knee. Muscles are the functional units that enable movement and strength of the appendicular skeleton.
The causes of injuries to tendons, ligaments and muscles can occur due to:

Symptoms of tendon and ligament injuries may include:

Again, if the injuries are serious, it may be necessary to resort to surgery, especially if they severely limit the patient’s ability to move.
Adequate muscle training and early diagnosis are essential to prevent the progression of the disease.

We have seen what the main orthopedic pathologies treated by regenerative medicine are.
Now we will delve into the treatments that are part of the methodical innovations brought by regenerative medicine, trying to provide a simple and exhaustive description.
Among the main treatments currently in use we can list:

PRP (Platelet Rich Plasma) is a regenerative therapy that involves taking the patient’s blood to separate the platelets, which are responsible for blood clotting and the formation of new tissues.
In addition to platelets, PRP contains various bioactive substances, such as cytokines and proteins, which aid in tissue healing and regeneration.

The use of PRP is particularly suitable for the treatment of:

To obtain platelet-rich plasma it is necessary to carry out a hematological evaluation and a peripheral venous blood sample which, through centrifugation and microfiltration, makes the drug available. Platelet-rich plasma is injected directly or under ultrasound control into the parts of the body affected by degeneration of connective tissues, with the aim of speeding up the healing of pathologies.

Many patients report rapid pain relief and improved function after PRP treatment, which can be even more effective than other traditional therapies. However, not all patients are candidates for PRP therapy, so it is important to consult a qualified doctor before deciding whether this treatment is right for you.

Mesenchymal stem cells (MSCs) are multipotent cells and of particular interest in orthopedics due to their potential to differentiate into cells that produce bone, cartilage, tendons and ligaments.
MSCs can be isolated from bone marrow, skin, synovium, adipose tissue and many other tissues of mesenchymal origin.

Mesenchymal stem cell therapy is currently indicated in the following orthopedic pathologies:

The MSCs from bone marrow are obtained from a small cannula, slightly larger than a needle, inserted directly into the iliac crest (area richest in cells) or at the level of the patient’s tibial tuberosity.
The cells coming from the adipose tissue are instead obtained from a small liposuction which is carried out in the operating room. The currently most used method is abdominal fat sampling.
In both cases, cells are obtained ready to be infiltrated into the pathological area.

Regenerative therapy using mesenchymal stem cells has a process that might seem complicated, but in reality it involves a minimally invasive intervention.
The regenerative benefits are:

Peripheral blood mononuclear cells are a group of blood cells, which include monocytes and lymphocytes, and are called mononuclear because they have a single nucleus within their cells. They are of fundamental importance for our immune system because they help fight infections and diseases.
Thanks to their ability to regenerate and repair damaged tissues, peripheral blood mononuclear cells have great therapeutic potential in various pathologies.

The pathologies used for mononuclear cell therapy in the orthopedic field are:

The process begins with a blood sample from the patient, in order to isolate the cells useful for the treatment and then be able to recover them.
The therapy consists of carrying out infiltrations in the pathological area and the treatment is rather quick and minimally invasive.

Hyaluronic acid is a substance that is produced by the human body to maintain hydration and lubrication of tissues, joints and eyes.
In both the aesthetic and medical fields, its uses are multiple.
In the first case, the administration helps to hide, for example, wrinkles and improve the aesthetic appearance of some parts of the face and body.
In this in-depth analysis we will discuss its use in the medical field.

In regenerative medicine, treatment with high concentration hyaluronic acid is mainly used to reduce pain and improve mobility in patients suffering from orthopedic pathologies.
The therapy involves injecting the substance directly into the joint that causes pain, with the aim of improving its functionality and consequently the patient’s quality of life.

Hyaluronic acid is often used to treat various orthopedic conditions, including:

The treatment is usually well tolerated by patients, however it is important to contact qualified professionals and structures to be sure of a successful outcome of the treatment and to be able to receive the correct instructions for post-therapy.
In fact, mild skin reactions may occur, such as:

All reactions are not serious, but in any case require the attention of a doctor.