IOA 2022

The 2020 NBA Orthobiologics Consensus Statement

Ron Gilat 2 Brian Cole 1 John DiFiori 3 Scott Rodeo 3 Asheesh Bedi 4
1Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush University Medical Center, USA
2Department of Orthopaedic Surgery, Shamir Medical Center and Tel Aviv University, Israel
3Orthopaedic Surgery, Hospital for Special Surgery, USA
4Department of Orthopaedic Surgery, The University of Michigan, USA

This 2020 NBA Orthobiologics Consensus Statement provides a concise summary of available literature and practical clinical guidelines for team physicians and players. We recognize that orthobiologic injections are a generally safe treatment modality with a significant potential to reduce pain and expedite early return to play in specific musculoskeletal injuries. The use of orthobiologics in sports medicine to safely reduce time loss and re-injury is of considerable interest, especially as it relates to the potential impact on a professional athlete. While these novel substances have potential to enhance healing and regeneration of injured tissues, there is currently a lack of robust data to support their regular use at this time. There are no absolutes when considering the implementation of orthobiologics, and unbiased clinical judgment with an emphasis on player safety should always prevail. Current best evidence supports the following:

· There is support for the use of leukocyte-poor PRP in the treatment of knee osteoarthritis.

· There is support for consideration of leukocyte-rich PRP for patellar tendinopathy.

· The efficacy of mesenchymal stromal cell (MSC) injections in the management of joint and soft tissue injuries remains unproven at this time. There is very little data to suggest that current cell therapy treatments lead to any true functional tissue regeneration. Meticulous and sterile preparation guidelines must be followed to minimize the risk for infection and adverse events if these treatments are pursued.

· Due to the high variability in orthobiologic formulations, team physicians must stay up-to-date with the most recent, peer-reviewed literature and orthobiologic preparation protocols for specific injuries.

· Evidence-based treatment algorithms are necessary to identify the optimal orthobiologic formulations for specific tissues and injuries in athletes.

· Changes in the regulatory environment and improved standardization are required given the exponential increase in utilization as novel techniques and substances are introduced into clinical practice.