Orthobiologics: Optimizing the Joint for Restoration or Delaying Arthroplasty

New medical interventions have helped people live longer and healthier lives, which has been accompanied by the expectation of patients remaining active even into their eighth decade and beyond. Unfortunately, advances in the orthopaedic literature for joint preservation have lagged behind. Research into techniques for joint preservation with the goal of delaying arthroplasty have risen to the forefront due to the tremendous physical and economic burden associated with osteoarthritis. One component has been the field of orthobiologics, the class of therapies that utilize biological products to enhance the body's natural healing process. Several potential candidates have emerged and entered the public consciousness, which portends increasing interest into these therapeutics. Among these possibilities include hyaluronic acid, platelet-rich plasma, bone marrow aspirate concentrate, and mesenchymal stem cells (MSC's). Despite concerns regarding the efficacy and cost-benefit ratio, both the basic science and the clinical data have supported their use to varying degrees. Further research remains to provide concrete guidelines for clinicians to provide optimal care for their patients.