Orthobiologics and Stem Cells in Orthopaedics – Principles, Applications and Evidence

Orthobiologics are biologically derived treatments used to enhance healing of bone, cartilage, tendon, ligament and other musculoskeletal tissues. Common options include autologous bone graft, PRP, BMAC, bone graft substitutes, growth factors and cell-based therapies. PRP mainly provides platelet-derived signalling molecules, while BMAC is a heterogeneous marrow concentrate containing only a small proportion of mesenchymal stromal cells and should not be equated with purified stem-cell therapy. Stem-cell-based strategies may act through differentiation, paracrine signalling and immunomodulation, but their clinical effectiveness varies widely according to cell source, processing and indication. Orthobiologics should be used as an adjunct to sound mechanical principles and evidence-based patient selection, with careful distinction between symptomatic improvement and true tissue regeneration.