Advanced biologic therapies used to treat musculoskeletal injuries are clearly on the horizon and who better than sports medicine physicians to offer that aid to patients? Injected biologics have been used to alter the body's properties since the 1950s. Such therapies, which are used routinely today to treat spinal and musculoskeletal conditions, are based on the supposition that the body's natural healing mechanism involves
inflammatory agents.
The science of prolotherapy was thus born to induce an in vivo proinflammatory state that promotes healing. The effectiveness of prolotherapy, which is a very nonselective way of inducing a biologic response via the body's natural healing mechanisms, has received mixed reviews in the literature, but it is regularly used by our physicians with a great deal of safety and success
The latest wave of natural biologics is platelet-rich plasma(PRP) in which the patient donates his or her own blood for harvesting of the body's natural healing biologics, which, subsequently, are injected to a targeted area to enhance healing. Although platelet-rich plasma makes intuitive sense and may be a step in the right direction, the literature yields mixed reviews of its efficacy, but it is gaining more and more support for resistant musculoskeletal conditions.
In the future, the focus of biologic therapy in sports medicine will likely shift to stem cell therapy, which has the potential to offer treatments that we can only imagine at this time. Research is beginning to demonstrate that, via a pluripotent stem cell ( a cell that can be taught), cells may be generated by reprogramming a patient's own dermal fibroblasts, adipose tissue, or bone marrow. In addition, results of preliminary studies suggested that stem cells assist with the healing of meniscal tears, tendon repair, and intervertebral disk repair. With the anticipated advancements in the use of biologics, someday we may be able to stimulate the body's natural healing process and prevent the need for more-invasive therapeutic procedures.
