THE FIRST ACADEMIC ORTHOBIOLOGICS PROGRAMS IN NORTHERN CALIFORNIA

Our Approach to Orthobiologics and Regenerative Medicine

Orthobiologics is an emerging field in orthopedic surgery and sports medicine that utilizes natural substances derived from human cells and tissues to promote healing. At Stanford's academic center,one of the first academic orthobiologics clinics since 2011, our team of renowned researchers and clinicians are pioneering innovative orthobiologic therapies that harness the body's own healing mechanisms. These cutting-edge treatments, such as bone marrow cell, adipose tissue therapy, platelet-rich plasma (PRP) injections, and tissue engineering, are designed to effectively relieve discomfort from musculoskeletal injuries and degenerative conditions while avoiding traditional surgical interventions. By leveraging the power of the body's reparative cells and growth factors, orthobiologics offers promising solutions for conditions like osteoarthritis, tendon and ligament injuries, and cartilage defects, potentially reducing recovery times and improving long-term outcomes for our patients.

Our team is actively pursuing pioneering research in stem cell therapies and advanced tissue engineering techniques, with the goal of developing innovative regenerative treatments that can further improve healing and recovery for a wide range of orthopedic injuries and degenerative conditions.

William J. Maloney, MD
Department Chair of Orthopaedic Surgery

WHAT WE OFFER YOU WITH ORTHOBIOLOGIC TREATMENT

Multidisciplinary team of orthopaedic surgeons, sports medicine doctors, advanced practice providers, and physical therapists to advise each patient on the best treatment approach
Leading-edge research to discover new and innovative ways to use orthobiologic treatments for all types of musculoskeletal injuries and conditions

Nationally and internationally recognized experts with highly specialized training and experience, leading the way in advancing the use of orthobiologic therapies for our patients
Expert second opinions on treatment options for sports injuries, including regenerative medicine

What Is Orthobiologics and Regenerative Medicine?

OVERVIEW

About Orthobiologics and Regenerative Medicine

Orthobiologics, a branch of regenerative medicine, encompasses the utilization of autologous or allogenic biological substances for the treatment of acute musculoskeletal injuries and chronic degenerative conditions affecting muscles, bones, joints, and soft tissues (ligaments, tendons, and cartilage). This innovative approach harnesses the body's innate healing mechanisms by leveraging cellular components derived from the patient's own tissues or donor sources.

The most commonly employed cellular and tissue sources in orthobiologic therapies include:

Adipose (fat) tissue
Bone marrow
Blood

Orthobiologic therapy involves the direct injection of these autologous or allogenic cellular components, such as platelets or subtances from bone marrow, adipose tissue, into the affected joint, ligament, tendon, or cartilage region. Upon administration, these biological agents potentially exert anti-inflammatory effects, facilitating pain relief, promoting tissue healing, and enhancing function and well-being.

Orthobiologics present a promising alternative for individuals who are unsuitable candidates for surgical interventions or have sustained injuries that are refractory to conventional surgical repair. These therapies can be employed as standalone treatments or integrated into comprehensive treatment plans encompassing surgical procedures, physical therapy, or a combination thereof.

At Stanford Health Care, our team of esteemed clinicians and researchers are pioneers in the field of orthobiologics, having provided safe and efficacious regenerative medicine treatments for musculoskeletal injuries for over a decade. Our physicians and surgeons actively contribute to cutting-edge research endeavors aimed at expanding the applications of orthobiologics and optimizing patient outcomes following injury.

Our multidisciplinary team, comprising orthopedic surgeons, sports medicine specialists, and advanced practice providers, clinic coordinators is committed to guiding patients through a comprehensive evaluation of all available treatment options, ranging from minimally invasive therapies to surgical interventions.

To schedule an appointment for orthobiologics clinic, please call 650-723-5643. We recommend preparing relevant medical records, including current assessments, clinical notes, and previous imaging studies to facilitate a thorough evaluation during the appointment.

CONDITIONS TREATED

Conditions Treated With Orthobiologics and Regenerative Medicine

Osteoarthritis Orthobiologic therapies offer promising alternatives for managing osteoarthritis, a degenerative joint condition characterized by the breakdown of cartilage. By injecting orthobiologic agents such as adipose tissue, bone marrow or platelet-rich plasma (PRP) into affected joint, we aim to reduce inflammation, and alleviate pain associated with osteoarthritis.

Tendon and Ligament Injuries Orthobiologics hold significant potential for treating various tendon and ligament injuries, including tennis elbow, patellar tendinitis, hamsting tendinitis, achilles tendinosis. These regenerative therapies can stimulate the body's natural healing processes, potentially reducing the need for invasive surgical interventions and accelerating recovery times.

Cartilage Defects Cartilage damage, whether due to injury or degenerative conditions, can significantly impact joint function and mobility. Our orthobiologics approach employs techniques such as microfracture augmentation with stem cells or tissue-engineered cartilage implantation, aiming to facilitate cartilage regeneration and restore joint health.

Muscle Injuries Orthobiologics offer promising solutions for treating various muscle injuries, including strains, tears, and contusions. By injecting regenerative agents like stem cells or PRP into the affected area, we aim to promote muscle healing, reduce inflammation, and enhance functional recovery.

Bone Fractures and Nonunions In addition to soft tissue injuries, orthobiologics may play a role in improving outcomes for certain bone fractures and nonunions (fractures that fail to heal properly). By introducing regenerative agents like stem cells or growth factors, we seek to stimulate bone healing and potentially reduce the need for invasive surgical interventions.

At Stanford, our team is dedicated to advancing the field of orthobiologics through ongoing research and clinical trials. We continuously explore new applications and refine existing techniques to provide our patients with the most effective and cutting-edge regenerative treatments available.To find the best treatment options for your, pleae consult our orthobiologics experts.

TYPES

Types of Orthobiologic and Regenerative Medicine Treatments

Stanford Medicine orthopaedic providers offer different types of orthobiologic treatments. They differ in the kind of source of orthobiologics injected to encourage healing.

Platelet-rich plasma (PRP) injections

PRP injections begin with drawing your blood. The blood sample is put into a special machine, called a centrifuge, to separate red and white blood cells, leaving behind plasma and platelets. Then the platelet-rich plasma is injected into the site of pain or injury. Platelets release growth factors to potentially decrease inflammation and pain, and stimulate healing.

Bone marrow aspirate injections

Bone marrow aspirate injections use cells and tissues from the bone marrow, a soft, spongy tissue inside your bones. Your doctor extracts (harvests) bone marrow, usually from the pelvic bone.

After numbing the area where they will extract the bone marrow, the doctor inserts a needle into your hip bone. Your doctor collects a small amount of bone marrow into a syringe, filters the sample, and places it into a centrifuge to concentrate the bone marrow. Then the doctor injects the concentrated bone marrow into the injured area.

Adipose tissue injections

Adipose tissue is body fat. To extract fat cells, your doctor performs a procedure called lipoaspirate, which is similar to liposuction but much less invasive. After numbing, your doctor inserts a cannula (thin tube) into the stomach, buttocks, or thighs to obtain a fat sample. Your doctor processes the fat tissue to separate the blood and oil and injects the cells into the injured or diseased area.

Understanding stem cell therapies

Regardless of claims and advertisements, stem cell therapies are currently not available for use in standard outpatient clinics. Stem cells are unique and specialized cells that can develop into many different types of cells and are capable of self-renewal. When you are injured, stem cells travel to the injury to help with the healing process.

It takes time for the body to repair damaged bone or soft tissue, and you may need more than one injection. Additional injections may be spaced out over several weeks or months. Patients typically begin experiencing pain relief and improved function within eight to 12 weeks.

While there are many research projects in progress, there are currently no stem cell therapies approved by the FDA to treat osteoarthritis or tendinopathy. Stem cells are extremely hard to produce and studies submitted to the FDA typically involve cell therapies and not stem cells.

While orthobiologic treatments are commonly referred to as stem cell therapy or regenerative medicine, we recommend against the use of these terms. This is in order to avoid any confusion with true stem cell therapy and to avoid misleading patients about tissue regeneration with orthobiologic treatments. In fact, it is not clear whether current orthobiologics regenerate the damaged tissue back to the preinjury status. Additional research is being conducted to answer these questions.

TECHNIQUES

Techniques for Orthobiologic Injections

Our doctors complete additional training for orthobiologic injections and teach other doctors. Doctors often use ultrasound to guide injections. Ultrasound is an imaging technique that uses high-frequency sound waves to create an image on a computer screen. The ultrasound shows tissues and bones under your skin so your doctor can guide a needle to the exact injury site in your joint or soft tissue.

CONTACT

MAKE AN APPOINTMENT

Our Team

Constance Chu, MD

Co-Director, Surgical Orthobiologics, Professor

Orthopaedic Surgery, Sports Medicine

Learn more about Dr. Chu

Eugene Y. Roh, MD

Co-Director, Non-Surgical Orthobiologics, Clinical Associate Professor

Physical Medicine and Rehabilitation, Sports Medicine

Learn more about Dr. Roh

Clinical Trials

Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.