Best Orthobiologic treatment Chennai India, Joint, Bone, Tendon, Ligament treatment

What is Orthobiologic treatment?

Orthobiologic treatment Chennai India is defined as any modality which harnesses the healing potential of the body’s own cells, redirecting their use for accelerated healing in damaged and diseased tissues of the musculoskeletal system (Joints, bone, ligament, tendon, fascia). In common parlance, the term “orthobiologic” refers to a biologic product used in the orthopedic setting to augment healing or alter the natural course of orthopedic disease. Orthobiologic treatments are thus disease-modifying as they help you to heal better.

Most orthobiologic treatments are performed by injections under image guidance like ultrasound or fluoroscopy. They may also be done by arthroscopic or open surgery.
The most common condition requiring Orthobiologic treatment Chennai India is knee osteoarthritis.

Which biologicals do I use?

I use Platelet-rich plasma (PRP), Growth factors, Stromal vascular fraction (SVF), Platelet-rich stroma (PRS) derived from adipose tissue or fat routinely, and bone marrow concentrate (BMAC) rarely.  Fat is better than bone marrow concentrates for the following reasons.
1) Fat can be easily harvested.
2) Fat has more progenitor cells per unit volume than bone marrow.
3) The availability of bone marrow decreases due to osteoporosis in the elderly

1) Platelet-rich Plasma (PRP)– Platelets are a type of cell in your blood. They are primarily responsible for clotting. They also contain chemicals known as growth factors which support healing and recovery processes. Platelet-rich Plasma is a filtrate of Plasma rich in platelets. In PRP, plasma contains significantly more platelets than normal, so the concentration of growth factors can be five to ten times higher. Platelets are known to provide a diverse array of growth factors that can work independently or with other proteins and cells to improve the healing process.

2) Medicinal signaling cells (MSCs). Medicinal signaling cells (MSCs) were previously known as mesenchymal stromal cells. These are multipotent cells widely present in body tissues. The main sources of cells in adults are bone marrow and fat.  These cells can stimulate the resident cells inside a joint or bone to differentiate into cartilage and bone. They do this by an action known as the ‘paracrine effect” which is a signal by chemical mediators (medicines) to the resident cells in a tissue, inducing them to proliferate and repair the damaged tissue. Other effects are by immuno-modulation and direct engraftment.  

3) Cultured specialized cells – Chondrocytes are specialized cells present in joint cartilage. Normally these cells multiply slowly and can repair small areas of damage in young patients. In “autologous chondrocyte implantation” these chondrocytes are first harvested and multiplied in the lab. They are then placed by a surgical method over a cartilage lesion.

Some of the common conditions treated by Orthobiologics are discussed below.

1) Osteo-arthritis – This is the most common condition that can be treated by Orthobiologic treatment in Chennai India. Osteoarthritis of the knee is most prevalent in India. Although PRP may provide short-term relief in incredibly early cases, mild to moderate osteoarthritis often needs SVF or bone marrow stem cell treatment. Surgery is reserved for late cases with bone-on-bone contact. Additional procedures in the knee may often be needed like a meniscal repair, meniscal transplant, osteotomy, and ACL reconstruction.

2) Cartilage lesion- A cartilage lesion is a localized area of damaged joint cartilage. It is the precursor of osteoarthritis. I treated symptomatic cartilage lesions with autologous chondrocyte implantation and one-stage cartilage repair. They can also be treated with scaffolds.

3) Bone conditions- Avascular necrosis of the hip, delayed, and nonunion can be treated with stem cell therapy.

4) Bone marrow lesions occur in the subchondral area of joints. They are present in several conditions including osteoarthritis. In osteoarthritis, they are one of the principal areas of pain production. Bone marrow lesions are treated by sub chondroplasty using platelet-rich plasma or bone marrow concentrate.

5) Knee injuries– Sprains of the MCL, LCL, Menisci, and tendon injuries are treated. See this infogram.

6) Shoulder joint- Rotator cuff tears, cartilage lesions, and osteoarthritis are treated with PRP & stem cells.

7) Hip joint- Augmentation of hip labral repair. Hip labral tears are common in India in young active individuals. This leads to hip pain and is the forerunner of osteoarthritis of the hip. Hip labral reconstruction is a new area in which biological products like PRP and bone marrow concentrate are used.

8) Lumbar Facet joints – These are the small joints in your lower back that allow you to twist and turn. Facet joint arthritis is a disabling cause of low back pain in middle age. When conservative treatments have failed, biological injections can help to alleviate low back pain for several years. I offer facet joint injections with MSCs for low back pain.

9) I treat joints like the ankle, elbow, wrist, hand, and fingers with Orthobiologic injections.

Surgical Orthobiologic procedures. – These procedures are done either by keyhole or open surgery. Some of the common operations are marrow stimulation, autologous chondrocyte implantation, and single-stage cartilage regeneration.

I also offer joint preservation procedures of the knee, hip, and other joints like osteotomy, ACL reconstruction, Meniscal repair, replacement, cartilage repair, MPFL reconstruction, rotator cuff repair, etc.

Let’s look at the evidence for biological treatments.

1) PRP can offer pain relief for up to nine months in early osteoarthritis.

2) SVF is more effective in mild to moderate cases of osteoarthritis.

I have satisfied bone marrow-treated patients reporting three-year pain relief.
I have follow-up video testimonials from SVF patients.
I also have MRI evidence demonstrating healing of bone marrow lesions following bone marrow stem cell treatment.

Advantages of Orthobiological treatments–

1) They are safe.
2) They are effective.
3) They are cost-effective.
4) A joint replacement can be postponed or avoided.

Common degenerative conditions of knee, shoulder, hip, fracture non unions and soft tissue injuries can be treated with orthobiologics

1. 1. Patients with knee joint pain from mild to moderate osteo-arthritis may benefit from ortho-biologic treatment after trying other conservative measures.
   2. Medically unfit for knee replacement but still suffering from knee joint pain and desirous of pain relief

1. 1. Obese patients with BMI > 35.
   2. Bone on bone disease ( IKDC grade D). Total knee replacement is the definitive treatment
   3. Uncontrolled inflammatory arthritis like Rheumatoid arthritis and sero-negative arthritis. You may consult your rheumatologist for medical management. I offer joint replacements for advanced cases. See my website
   4. Young patients with post-traumatic arthritis and gross deformities. A complex knee replacement is necessary.
   5. Uncontrolled diabetes.
   6. Patients with gross deformities. ( They may need an additional reconstructive procedure simultaneously to correct mal-alignment like an osteotomy.

Although patients with knee OA are most common, others with AVN hip, rotator cuff tears, tennis elbow, foot conditions and fracture non unions also seek help.

He pioneered micro-fracture of knee in Chennai in 2004 . He pioneered autologous ossron implantation ( 2013), autologous chondrocyte implantation (ACI)  in Chennai in 2014. He has now pioneered stromal vascular fraction treatment (SVF treatment) in Chennai, India. He has undergone training for cartilage repair, bone marrow, fat harvesting and guided injections in the USA.  He has done signaling cell & PRP procedures for hip, knee, elbow, ankle, foot and shoulder. He chairs the ethics committee  of a company for development of cellular products.
Our procedures are done only in Chennai after thorough clinical and radiological evaluation.

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Orthobiologic treatment Chennai India mentioned in this website are medical techniques that may or may not be considered mainstream. As with any medical treatment, results will vary among individuals, and there is no implication that you will heal or receive the same outcome as patients herein. There could be pain or other substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees of healing.