Orthobiologics: Evidence and Regulation

Orthobiologics are biological preparations made from blood, bone marrow, fat or cultured cells and injected into musculoskeletal tissue to try to improve pain or healing.

They include platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), adipose-derived preparations and culture-expanded cell therapies, often marketed as stem cell treatments. The commercial claims run well ahead of the evidence.

For the sport and exercise medicine (SEM) clinician the skills are critical and regulatory: knowing what each preparation is, how limited the evidence is, which UK bodies regulate what, and how to counsel an athlete offered an expensive unproven treatment, often abroad.