Arthurs, Jennifer

Abstract Within the field of regenerative medicine for musculoskeletal regenerative medicine, orthobiologics and cellular therapies are evolving at a rapid pace. Exuberant ideas for new treatments often outpace their scientific evidence, which may create confusion for both patients and providers on what treatments are evidence based. Orthobiologics and cellular therapies are a subset of regenerative therapies focused on treatment of musculoskeletal disease. For the field of orthobiologics to progress, it is essential that musculoskeletal providers understand the necessary components for translating novel therapies from discovery into practice. In this article, we provide an overview of both the lexicon and regulatory processes related to translation of orthobiologics and cellular therapies along with a comparison of how to translate orthobiologics and related novel cellular therapies in hopes to dispel misinformation while promoting responsible advancements and ethical practices in medicine.

Background: The regenerative properties of platelet growth factors make platelet-rich-plasma (PRP) an attractive modality for treatment of aging skin. The main objective of this study was to determine efficacy and safety of PRP injections and microneedling compared with saline injections in women with aging skin of the face. Methods: In this prospective, randomized clinical trial, 18 women with facial aging were randomized to receive either PRP injections to the unilateral face and saline injections to the contralateral side, or vice versa. Microneedling was performed after injections on the entire face. Physician assessment, photographs, and treatment satisfaction questionnaires were used for outcome assessment at baseline and 16- and 24-week follow-ups. Results: There was no evidence of improvement and suggestion of worsening in skin laxity and rhytides from baseline to weeks 4, 16, and 24 for PRP and saline (all P ≤ 0.004) and no notable difference in skin roughness between baseline and follow-up time points for PRP or saline (all P ≥ 0.19). The degree of change in skin laxity, rhytides, and skin roughness from baseline to follow-up time points was similar for PRP and saline. All patients experienced some degree of pain/discomfort and burning/stinging sensation at treatment weeks 4, 8, and 12 for both saline and PRP. Conclusions: PRP injections did not seem to be effective for treatment of aging skin of the face in women, with no notable macroscopic improvement in appearance when compared with baseline or saline injections. Advanced age of study participants (>45 years) and less-sensitive methods of evaluation may be potential contributing factors to the lack of detected response.