Traditionally, orthopaedic surgeons used surgery or immobilized injuries to restore only biomechanics, trusting that Mother Nature and luck would do the rest and, better or worse, the bone would heal or the tendon would heal over the metal or suture, or within the bone.
But my old teachers have already taught me that healing cannot be imposed, but must be cultivated.
Regenerative Medicine is the part of Medicine that deals with enhancing the body’s ability to restore or grow again a part of the body that has been damaged by an accident or by aging, enhancing the capacity of natural healing of the body.
This applies both to injuries and to chronic degenerative processes (osteoarthritis, ligament injuries and tendinitis), where the damage cannot be fully resolved by the body’s normal healing mechanisms.
Orthobiology not only serves to delay or avoid surgery, but is also used to complement it: along with minimally invasive surgeries such as arthroscopy, Regenerative Medicine is used to improve its results
The most common therapies are:
-Growth factors and cytokines: these are proteins that we obtain from the patient’s blood and that facilitate the work of cells to form healthy tissue and control inflammation.
-Mesenchymal cells: they are capable of reproducing and differentiating into cells of different tissues: bone, cartilage or tendon, and they are mobilized and activated when the tissue has been damaged and must be repaired.
In addition, these cells produce growth factors and cytokines that promote healing and in turn attract more reparative cells.
-Biomaterials: molecules that are part of our tissues, such as Hyaluronic Acid or Collagen, are used and modified to form meshes or gels that serve as “scaffolds” on which repair cells grow and also promote their multiplication , which in turn secrete growth factors.
These treatments in most cases only require a blood extraction and an injection in the damaged part, although sometimes we use non-aggressive surgery, such as arthroscopy, to implant them.
In general, different combinations of these treatments are used to achieve the maximum benefit in each patient.
As an analogy, we could put a gardener, who plants seeds (which would be the stem cells) and waters them (the water and fertilizer would be the growth factors and cytokines) so that the plant in your body sprouts and flourishes.
Wow, we traumatologists are going from being mechanics to being gardeners!
Dr. Luis Gallego