Hype, Promise and Reality: Orthopaedic Use of Biologics in 2024 (2024 Annual Meeting)-Hype, Promise and Reality: Orthopaedic Use of Biologics in 2024

Video Transcription

Video Summary

The presentation offers a comprehensive overview of biologic therapies in orthopedics, focusing on platelet-rich plasma (PRP), tendon treatments, cartilage regeneration, cell therapies, and regulatory considerations.<br /><br />Ken begins by discussing PRP for knee osteoarthritis (OA), highlighting its components—platelets, cytokines, growth factors—and clinical evidence showing PRP’s superiority over hyaluronic acid, corticosteroids, and placebo in improving pain and function. He emphasizes the importance of understanding PRP composition, particularly platelet and leukocyte concentration, dosing effects, and patient response variability. Autologous protein solution (APS), a white-cell-rich PRP variant enhancing anti-inflammatory cytokines, shows promise in longer-term outcomes.<br /><br />Scott reviews tendinopathy treatment, outlining the complex biology of tendon injury involving matrix changes and molecular inflammation. PRP’s effects are variable; leukocyte-rich formulations may better stimulate healing, but evidence is mixed, especially for rotator cuff tendinopathy. He discusses cell therapies from bone marrow and adipose tissue, noting limited but emerging evidence for improved structural healing in rotator cuff repair. He advocates considering patient metabolic factors and rehabilitation protocols, highlighting the need for precision medicine approaches and biomarkers.<br /><br />Jason covers cartilage therapies, distinguishing adipose-derived preparations that reduce inflammation but lack regenerative capacity from progenitor cell therapies showing cartilage regeneration in randomized trials internationally. He showcases arthroscopic juvenile cartilage implantation techniques and emerging FDA-regulated trials using autologous and allogeneic cells, projecting expanded U.S. availability soon.<br /><br />Steve Weber details FDA regulatory frameworks distinguishing minimally manipulated (361) from more complex (351) biologics, emphasizing recent enforcement actions against non-compliant stem cell and amniotic products. He underscores legal risks, warns against misinformation, and advises clinicians to stay informed via official resources.<br /><br />Overall, biologics represent a rapidly evolving field with growing evidence supporting specific PRP and cell therapies, particularly for OA and tendon repair, while regulation tightens to ensure safety and efficacy. Precision medicine and rigorous research are critical for optimizing patient outcomes.

Asset Caption

Stephen C. Weber, M.D., Moderator | Scott A. Rodeo, M.D. | Kenneth R. Zaslav, M.D. | Jason L. Dragoo, M.D., FAANA

Keywords

biologic therapies

orthopedics

platelet-rich plasma

PRP

tendon treatments

cartilage regeneration

cell therapies

regulatory considerations

osteoarthritis

tendinopathy

FDA regulations