Biologics in Orthopedic Surgery

Preserving the Articulating Surface of the Knee

Introduction Hyaline articular cartilage plays an integral role in the function of the knee joint. Isolated chondral lesions are incompletely understood, but once damaged, there is very little capacity for spontaneous healing due to intrinsically poor blood supply ( Fig.…

Bone Loss in the Upper Extremity

Introduction Bone loss is a serious problem that can affect any part of the body, both anatomically and functionally, and it must be considered and addressed appropriately. When examining the upper extremity specifically, an area that must be considered extensively…

Rotator Cuff Augmentation

Introduction Massive rotator cuff tears are often chronic in presentation and complicated by poor tendon quality, muscular fatty atrophy, tissue retraction, and scarring. For these reasons, successful footprint repair and tendon healing may be difficult and can result in retear…

Biologics in Sports Medicine—Introduction

Disclosures Laura A. Vogel declares no conflicts of interest; Mary Beth R. McCarthy receives intellectual property royalties from Arthrex, Inc. Augustus D. Mazzocca is a paid consultant for Arthrex, Inc. and Orthofix, Inc. and receives research support from Arthrex, Inc.…

Allograft Tissue Safety and Technology

Disclosure Statement Dr. Moore, Mr. Samsell, and Dr. McLean are employees of LifeNet Health, a nonprofit organization. Introduction Biologic tissues are among the many clinical options available to orthopedic surgeons, with over 1 million annual implants of human allografts alone.…

Biologics in Orthopaedic Surgery

Bone Marrow Aspirate Concentrate Bone marrow aspirate concentrate (BMAC) is derived from fluid obtained from bone marrow. Given the source of origin, BMAC contains a composition of cells—mesenchymal stem cells (MSCs), hematopoietic stem cells, endothelial progenitor cells, white blood cells,…

Growth Factors

Introduction There have been significant advancements over the last several decades in the field of orthopedic surgery with regard to our understanding of biomechanics, tissue healing, and the pathogenesis of musculoskeletal diseases. Biologics and regenerative medicine have received significant attention…

FDA Regulations and Their Impact

Disclosure Statement Anz: Consultant for Arthrex; Pinegar: no disclosures. Introduction Progress of biologics in orthopaedic surgery, or orthobiologics, currently faces a delicate balance involving providers sprinting to apply clinically and profit on unproven technologies and the marathon of technology development…