Biologics including Adult Mesenchymal Stem Cells (MSCs), Platelet Rich Plasma (PRP), Structural Acellular Collagen Allograft, and Conditioned Media (Autologous Exosomes) are under investigation for regenerative purposes and as a means of postponing, perhaps avoiding a joint replacement for an arthritic joint. The use of autologous therapies has proven safe and effective when the FDA mandates are followed by the credentialed physician. To illustrate the complexity of the emerging discipline of Regenerative Medicine, I will use Platelet Rich Plasma (PRP) as an example.
In a recently published scientific article regarding Platelet-Rich Plasma, the author provides a systematic review of preclinical studies and clinical evidence on PRP for joint regeneration concluding that the preclinical literature shows overall support toward this PRP application. An intra-articular injection does not just target cartilage; instead, PRP might influence the entire joint environment according to the study authors Berardo Di Matteo and Elizaveta Kon.
Given the biocompatibility of using the patient’s own proteins, safety is guaranteed. PRP therapies are much more complex than previously thought, and their discovery has opened the door to a vast labyrinth of new questions. The effectors mediating the beneficial effects of PRP have not been identified and platelets contain more than 300 proteins; all this according to the investigator Isabel Andia.
Then there is the question of whether to inject the PRP into the joint (intraarticular-IA), into the bone (intraosseous-IO), or both? In a recent article written by Sanchez, et.al., the PRP is injected into both acting on the cartilage-bone communication as well as inside the joint. It has long been recognized that the subchondral bone plays a role in the progression of Osteoarthritis.
Readers of my Blog should be familiar with subchondroplasty, intraarticular injections of Biologics, and a combination of both. I have written several significant scientific outcomes articles about the various approaches. Returning to my original question, might a non-physician or non-scientist ever understand Biologics and Regenerative Medicine for an arthritic joint? I think not; so, for those with symptoms and limitations generated by an osteoarthritic joint, schedule a consultation by calling (312) 475-1893. You may visit my website at www.sheinkopmd.com.