What Are Orthobiologics? A Clear Guide for Clinicians

What Are Orthobiologics? A Clear Guide for Clinicians

Jun 25, 2025

Oscar Tellez

What Are Orthobiologics? A Clear Guide for Clinicians

Orthobiologics are biological substances used to assist in the healing of musculoskeletal injuries. These include materials derived from the patient or donor sources that may support tissue repair, reduce inflammation, or promote functional recovery. This guide explains what orthobiologics are, how they are used in orthopedics, and what clinicians should consider when integrating them into care.

What Are Orthobiologics?

Orthobiologics are natural substances used in orthopedic care to support the body’s natural healing processes. They may include concentrated blood products, bone graft materials, or cell-based preparations. The goal is to improve healing environments in bone, cartilage, ligament, and tendon injuries.

Common Types of Orthobiologics

  • Platelet-Rich Plasma (PRP): Concentrated platelets used to support soft tissue or joint healing.

  • Bone Marrow Aspirate Concentrate (BMAC): Contains a variety of cells, including progenitor cells.

  • Adipose-Derived Materials: Includes microfat and stromal vascular fraction (SVF).

  • Demineralized Bone Matrix (DBM): Processed bone graft material used in spinal and orthopedic procedures.

  • Synthetic Bone Substitutes: Used in bone void filling and structural support.

  • Amniotic Membranes and Fluids: Sometimes used for their signaling molecules and protective layers in surgery.

What Are Biologics in Orthopedics? 

Biologics in orthopedics refer to any biologically derived material that plays a role in musculoskeletal repair. These can be autologous (from the patient), allogeneic (from a donor), or synthetic with bioactive properties. Their aim is not to replace damaged tissues directly but to encourage favorable conditions for repair.

Mechanism of Action

  • Deliver cellular signals to injured tissues

  • Support cell migration and adhesion

  • Influence inflammatory response

  • Promote matrix production and remodeling

Use Case Examples

  • Knee Arthritis: PRP or microfat injections to support joint comfort

  • Rotator Cuff Repair: BMAC or PRP added during surgery to assist tendon-bone healing

  • Spinal Fusion: DBM or synthetic grafts to support bone bridging between vertebrae

  • Achilles Tendinopathy: PRP injections to support collagen remodeling

  • Cartilage Defects: Matrix scaffolds with cellular materials for focal chondral lesions

Clinical Considerations for Use

Patient Selection 

Ideal candidates for orthobiologics include those with:

  • Early-stage osteoarthritis

  • Chronic tendinopathy

  • Ligament sprains or partial tears

  • Fractures with delayed healing

  • Post-operative support needs

Procedure Setting 

Orthobiologics can be applied in surgical and nonsurgical settings:

  • Intraoperative: BMAC during ACL repair

  • Outpatient: PRP injections for tennis elbow

  • Post-op: Microfat for soft tissue volume maintenance

Safety and Regulation 

All orthobiologic materials must be handled in sterile environments using FDA-cleared systems. Providers must follow regulatory guidance and avoid unproven claims. Documentation should support intended use and reflect realistic goals.

Integration Into Practice

Required Equipment 

Clinics may require:

  • PRP and centrifuge systems

  • Adipose processing devices

  • Bone graft delivery tools

  • Refrigeration for storage (if applicable)

Staff Training 

Clinical teams need hands-on training in:

  • Aseptic technique

  • Biologic preparation protocols

  • Ultrasound or fluoroscopic guidance (for injections)

  • Managing patient expectations and aftercare

Patient Education 

Patients should be informed that:

  • Orthobiologics aim to support recovery, not guarantee repair

  • Benefits are often gradual and individualized

  • Repeat treatments may sometimes be needed

  • Not all insurance plans cover these procedures

Advantages of Orthobiologics

Minimally Invasive Application 

Orthobiologics are often delivered via injection, avoiding surgical incisions. This makes them suitable for outpatient care and recovery.

Potential to Support Natural Healing 

By introducing biologically active material at the site of injury, clinicians may help stimulate cellular activities such as:

  • Angiogenesis

  • Fibroblast recruitment

  • Matrix deposition

Versatility Across Conditions 

Orthobiologics are used in both degenerative and traumatic conditions:

  • Osteoarthritis

  • Labral tears

  • Tendon degeneration

  • Nonunion fractures

Limitations and Ethical Considerations

Evidence-Based Use 

While promising, biologics must be used alongside established treatments. Overreliance or premature substitution can mislead care strategies.

Variability in Response 

Factors that influence outcomes:

  • Patient age and overall health

  • Quality of biologic material

  • Timing and site of application

Regulatory Oversight 

Clinicians must:

  • Use only FDA-approved or cleared systems

  • Disclose investigational or off-label use

  • Maintain detailed procedural documentation

How Accretion Portal Supports Clinical Use 

Accretion Portal provides regenerative systems including PRP platforms, adipose processing units, and support tools for orthobiologic preparation. We assist with:

  • Equipment selection

  • Clinical onboarding and training

  • Compliance and workflow planning

Our approach supports evidence-based adoption of orthobiologics for practices of various sizes.