No injection has been proven to reliably regrow lost cartilage in an arthritic joint. Orthobiologic treatments aim to reduce pain and improve function by influencing inflammation and the healing environment around injured tissue.
The right choice depends on the diagnosis, the condition of the tissue, and the evidence for that specific problem.
Surgical videos and explainers from the OrthoPedia patient education library, organized by regenerative medicine condition. Choose a condition, then pick a video.
Orthobiologic care works best as part of a complete treatment plan. These six principles guide the conversation about which treatment may fit your injury and recovery goals.
Platelet-rich plasma (PRP) is often the first biologic considered when an injection is appropriate. The formulation matters: leukocyte-rich (LR) and leukocyte-poor (LP) preparations contain different amounts of white blood cells. Dose, timing, and delivery also influence the response.
Bone marrow concentrate (BMC, also called BMAC) contains interleukin-1 receptor antagonist (IL-1Ra), a protein that blocks an inflammatory signal. Its composition may be relevant when persistent inflammation is part of the problem; it does not establish that BMC is the best option for every difficult case.
Microfragmented adipose tissue (MFAT) and adipose-derived mesenchymal stromal cells (AD-MSCs) are different fat-derived preparations. Researchers are studying their effects on tissue breakdown, scarring, and tendon repair. These potential effects are not proof of disease reversal or predictable tissue regeneration in patients.
A corticosteroid injection may help control an acute flare while a longer-term plan takes effect. Relief often wanes within weeks to a few months, so the decision to repeat an injection should consider the diagnosis, the tissue involved, and the response to prior treatment.
Biologic treatments support a recovery program; they do not replace it. Restoring movement, strength, and tolerance for activity requires a rehabilitation plan designed for the injured tissue and your goals.
PRP, BMC, adipose-based treatments, and combined preparations are not interchangeable. Selection should reflect the tissue involved, the inflammatory environment, and the available clinical evidence. This is an individualized decision, not an automatic progression to a more complex treatment.
The injection is one part of recovery. A successful plan addresses the whole injury, protects the treated tissue, and advances rehabilitation as healing allows.
Assess the joint and its supporting structures, including ligaments, tendons, muscles, and fascia. Treatment should address the affected tissues contributing to the problem, rather than focusing only on the most painful spot.
Limit excessive loading and stress during early recovery. Some tissue-specific protocols call for six weeks or longer of protection; the timeline depends on the injury and treatment. A brace, splint, or walking aid may be appropriate, with clear instructions about weight bearing and activity.
Exercise and loading should advance with the tissue's recovery. Clinical assessment, and dynamic imaging when appropriate, help guide safe progression. Joint rehabilitation aims to maintain mobility while unloading the treated area and limiting stress; soft-tissue rehabilitation uses protected, tissue-specific range of motion and gradually increased exercise. Return to daily activities, recreation, and sport is individualized.
Orthobiologics use biological materials to influence inflammation or healing around a joint, tendon, or ligament. PRP comes from your blood, BMAC from bone marrow, and MFAT from fat tissue. Their preparation and supporting evidence differ.
PRP injections concentrate platelets from a blood sample. BMAC contains a mixture of cells and proteins collected from bone marrow. MFAT preserves small fragments of fat tissue. The stem cell therapy page explains what marrow- and fat-derived preparations do and do not mean.
Peptides are short chains of amino acids. Some are approved medicines for specific conditions; others are marketed for recovery without adequate human evidence. The peptide therapy page addresses these distinctions, including considerations for competitive athletes.
Whether you have coverage depends on your plan and on the particular service, since there are two distinct services here.
First, there is an evaluation consisting of the office visit, examination, and any ordered tests including imaging studies; coverage for this part of the encounter follows the usual orthopedic benefits.
Second, there is the biologic procedure which has its own coverage criteria, and plans vary widely as to how they categorize these procedures.
No biologic can even be planned without a specific diagnosis, so the evaluation comes first regardless of what coverage exists for any later procedure. Your first phone call should ask about the orthopedic visit, not the biologic.
Before scheduling, call the member services number listed on the back of your insurance card. Ask whether a referral is required to see an orthopedic specialist. Ask whether imaging requires pre-authorization. And ask how the plan categorizes the specific procedure by name, since the answer will vary for each biologic. Request that information in writing if possible.
Ask your treating clinician whether the specific product is approved for the intended application. It could instead be investigational, or sold through another mechanism. A registered study, an entry in a clinical trials registry, and FDA approval to sell are all separate concepts. Adjectives such as "natural" and "cellular" are not relevant. Bring what you learn to the visit: when you request an appointment, the benefit question is already answered before treatment ever comes up. If a plan puts a biologic outside its benefits, that is information worth having early, because it shapes the conversation you and your surgeon will have.
An evaluation establishes what is causing your symptoms and whether a biologic has a useful role in your care. Dr. Langer discusses the expected benefit, the limits of the evidence, and alternatives such as shockwave therapy, alternatives to cortisone injections, or joint preservation procedures when appropriate.
Mechanical problems such as complete tendon tears or unstable joints may require a different treatment path. An injection does not replace a necessary repair or treatment for an infection.
Bring your activity goals, previous treatment history, and insurance questions when you request an appointment. The aim is a clear plan with a defined recovery goal and a point to reassess progress.
If pain is limiting the way you train, work, sleep, or move, an evaluation can turn uncertainty into a practical next-step plan.
Book an appointment →Explain what you want to return to, not only what hurts.
Look for the combination of findings that best explains the symptoms.
Understand the likely cause, whether imaging helps, and what comes next.
Atlanta Sports Medicine Institute helps active patients understand what may be driving their symptoms and compare appropriate treatment paths. The experience should be precise, understandable, and tied to the activities each patient wants to return to.
They're injections made from your own blood, bone marrow or fat, which are injected into an arthritic joint to reduce pain and improve function. The best-studied of these therapies for arthritis is platelet-rich plasma, while the bone marrow and fat ones have primarily been studied in the knee. What's true for a knee isn't necessarily true for a hip or a shoulder. They're not a substitute for lost cartilage. A trial may demonstrate that patients improved in pain and function, but doesn't show any improvement on joint imaging. The combination of those two outcomes is commonly reported in one breath when it shouldn't be. Where the arthritis is advanced, it's even more important to recognize the distinction.
Yes. PRP is an orthobiologic prepared from your own blood. Processing concentrates the platelets, which release proteins involved in inflammation and repair.
This section discusses PRP, marrow- and fat-derived preparations, peptide therapy, shockwave therapy, and alternatives to corticosteroid injections. These are distinct approaches: shockwave uses acoustic energy rather than a biologic injection, and peptide products vary in purpose and evidence. Each has its own page explaining what the treatment is, who it may fit, and where the evidence stands. The question of which treatment applies to you can only be answered at the visit. It depends on your diagnosis and how much structural damage already exists, which the examination and imaging decide. Reading these pages first just makes that conversation faster and better.
Coverage for regenerative medicine treatments varies by plan and by the specific procedure being considered. Our team can help verify your benefits and check whether prior authorization is required with your insurer before treatment. We recommend confirming details directly with your insurance provider, since plans differ in how they classify these treatments.
Regenerative medicine uses substances from the body, such as orthobiologics, to support the body's own healing response in injured or degenerated tissue. These approaches are used alongside a broader evaluation of the joint or injury rather than as a standalone fix. Your physician will discuss whether a regenerative approach fits your specific diagnosis and treatment plan.
Orthobiologic injections, including PRP, are part of the treatment options discussed on this page for joint conditions such as osteoarthritis. Whether an injection-based option is appropriate depends on your individual diagnosis and evaluation. For a full look at the treatment options covered in this section, see regenerative medicine.
Orthobiologics are one category of regenerative medicine discussed on this page, and PRP is one example within that category. These approaches are considered as part of a broader set of treatment options for joint and musculoskeletal conditions. For the full range of options this section covers, see regenerative medicine.
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