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Orthobiologics: the Art & Science of Using the Human Anatomy to Heal Orthopedic Injuries
On the first play of the second half of a football game against the Washington Redskins held December 24, 2011, record-setting running back Adrian Peterson of the Minnesota Vikings suffered a complete tear of his anterior cruciate and medial collateral ligaments and a major tear of his meniscus cartilage.
More recently, in a football game against the University of Tennessee held October 27, 2012, University of South Carolina running back Marcus Lattimore suffered the worst knee injury possible, tearing his anterior cruciate ligament, posterior cruciate ligament and lateral collateral ligament in his right knee.
If these world-class athletes suffered their injuries just three or four years ago, they would have been unable to compete for at least a full season to heal and rehabilitate the injury and most likely another four to six months just to be cleared to return to non-contact training.
Despite the severity of their injuries, Peterson and Lattimore were back on the field much sooner than anticipated. Peterson was on the field for the Vikings’ first game of the 2012 National Football League season and rushed for 2097 yards and was named MVP of the league. Lattimore is recovering rapidly and may be ready to play for an NFL team in November or December of this year.
The driving force behind their accelerated recoveries is the art and science of orthobiologics, which combines the body’s natural ability to heal itself and the use of stem cells and advanced medical technologies to repair and heal orthopedic injuries. By definition, orthobiologics is the inclusion of biology and biochemistry in the development of bone and soft tissue replacement materials for skeletal and tissue healing.
Perhaps the most familiar orthobiologic treatment is PRP therapy. Clinically referred to as “Platelet-Rich Plasma Therapy,” PRP is a holistic approach to speed the regeneration and healing of ligament, tendon and muscular injuries, reducing recovery time. Used since the 1990s to assist with the healing of spinal injuries and to facilitate recovery after plastic surgery, PRP garnered international attention when it was reported that PRP was used by Tiger Woods while he rehabilitated from micro-fracture surgery in 2008.
“Platelet-Rich Plasma is blood plasma with a high concentration of platelets with significant bioactive proteins,” says Craig Levitz, MD, chief of orthopedics at South Nassau Communities Hospital, “which are vital to the repair and regeneration of musculoskeletal soft tissue.”
PRP is extracted by drawing a small amount (approximately 10 CCs) of the patient’s blood into a test tube, which is then put in a centrifuge (lab equipment that spins at a high speed to create centrifugal force) to separate the blood into layers. The plasma and platelets are taken from the test tube, put in a syringe and then injected into the patient’s injured or surgically repaired area. The bioactive proteins activate tissue recovery, new blood vessel formation, bone regeneration and connective tissue repair.
Dr. Levitz was one of the first orthopedic surgeons and sports medicine specialists in the US to use the bio-patch and Carticel Therapy. Commonly referred to as the biologic rotator cuff implant, the patch relies on the body’s natural biological agents to jumpstart healing, even as surgery is in progress. The bio-patch is used most often for severe rotator cuff tears that will increase in size without surgical intervention and for chronic, non-healing rotator cuff tears.
“The (bio-)patch is the ideal solution for a patient with a large or chronic tear,” said Dr. Levitz. “This is a revolutionary approach to what is an otherwise hopeless, irreparable and painful shoulder injury.”
Carticel Therapy is a minimally-invasive surgical approach that uses patients’ cloned cartilage cells (chondrocytes) to correct recurring articular knee cartilage injuries. When implanted into a cartilage injury, the patients’ cells can form new cartilage, which is very similar to the original cartilage. The Carticel implantation procedure is called Autologous Chondrocyte Implantation or ACI.
For patients hampered by damaged meniscus cartilage despite previous operations and facing osteoarthritis and eventually a knee replacement, there is the meniscal cartilage transplantation. A revolutionary, minimally invasive surgical technique, meniscal allograft transplant hinders degeneration of the knee joint and eliminates the constant pain caused by the damaged cartilage.
The most widely used orthopedic transplantation technique, allograft tissue, comes from two sources: living donors undergoing primary joint replacements or cadaveric donors. Dr. Levitz performs most transplants arthroscopically.
“Regardless of the cause of the injury, the field of orthobiologics is very promising in the healing process,” said Dr. Levitz. “I look forward to providing the latest advances and options to the communities we serve.”
South Nassau provides the continuum of orthopedic care through its Center for Advanced Orthopedics, which includes the Long Island Joint Replacement Institute™ (LIJRI) and South Nassau Shoulder Center. The LIJRI is a recipient of the Joint Commission’s Gold Seal of Approval™ for its compliance and continuous dedication to the national standards for health care quality and safety as recommended by the Commission’s Disease-Specific Care Certification Program.
The Center for Advanced Orthopedics was established to meet the rapidly rising long-term need for full-service, specialized orthopedic care. In addition to specializing in orthobiologics, surgeons at the Center use minimally invasive and image-guided surgical technology to repair musculoskeletal injuries as well as to perform joint replacement surgery. For more information about the Center for Advanced Orthopedics or to schedule a consultation, call 1-877-South Nassau.