Biologics and injection therapy for the management of osteoarthritis

Osteoarthritis (OA) is a progressive degenerative joint disease that leads to considerable disability and plagues our aging population with pain and impaired function. There are currently no treatments that reverse or halt the progression of osteoarthritis. Various injection therapies have been developed, and biologic interventions continue to be investigated, showing early promising results.

Although there is conflicting evidence whether they are superior to steroids, Hyaluronic Acid injections are safe with a lower risk profile than oral anti-inflammatory medications.

Platelet Rich Plasma has a growing body of work giving evidence to support its use in the treatment of OA

A series of three injections of PRP has both pre-clinical and clinical evidence supporting its efficacy in the treatment of OA

Bone Marrow Aspirate has not outperformed PRP in a head-to-head study.

Initial promising adipose studies have employed collagenases, and FDA guidance suggests premarket development for orthopedic indications.

Amniotic products have early promising developmental work, and FDA guidance suggests premarket development for orthopedic indications

A global perspective of the patient must be considered when treating with biologic adjuncts in the setting of symptomatic knee OA: alignment, duration of symptoms, previous treatments, bone mass index (BMI), activity levels, etc.

Develop an evidence-based algorithm for patient discussions and read regulatory documents to determine comfort with every product available for patient care.

Intervening simply based on FDA approval may not provide durable nor reliable results when treating patients with symptomatic knee OA with biologic interventions

Do not take industry’s word for face value when approached with biologic treatment options. “FDA approval” may not mean what you think it means.