Helping you get back to living

Orthobiologics

Hours: Monday–Friday, 8am–5pm

Chronic pain or acute injuries can keep you from your work and enjoying your family life. For people living with this ongoing pain for weeks, months and years, this non-surgical option can provide great promise.

Orthobiologics, sometimes referred to as regenerative medicine, may help you postpone or avoid altogether, joint replacement or other surgical procedures. And while surgical options produce excellent results, the new world of orthobiologics may provide you with alternative, non-surgical options to relieve your pain, helping you get back to living faster.

How can orthobiologics help me?

Orthobiologics have been employed to help either with pain relief or healing of orthopedic ailments. Generally, its use can be placed into one of four categories of orthopedic injuries:

  • Chronic tendon injuries (i.e., tennis elbow, patellar tendonitis, and rotator cuff partial tears)
  • Acute soft tissue injuries (i.e., ligament, tendon or muscle strains or sprains)
  • Mild to moderate arthritis (i.e., knee, hip, and shoulder osteoarthritis)
  • Surgical augmentation (i.e., revision procedures)

What orthobiologics options do you offer?

DMOS offers four options, all commonly used to treat different musculoskeletal conditions, including arthritis, muscle strains, tendon and ligament injuries. The injection type differs based on the patient assessment and their individualized needs.

Platelet Rich Plasma (PRP)

By definition, PRP is a collection of growth factors (which are proteins that are important in the healing of injuries), that can have controlled levels of white and red blood cells, based on the healing process necessary. Laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process. Many world-class athletes use PRP therapy to repair their sports injuries faster.

Autologous Protein Solution (APS)

This injection serves to help as a local anti-inflammatory and reset the body’s natural balance in the arthritic joint. In technical terms, APS is a denatured PRP that delivers proteins, which block arthritic pain receptors. APS may be the preferred course of treatment based on if the patient exhibits radiographic evidence of knee, hip or shoulder OA (osteoarthritis).

Bone Marrow Aspirate Concentrate (BMAC)

Technically, BMAC is a collection of growth factors and cells, which include stem cells. Physicians use BMAC when they believe the potential upside of containing mesenchymal stem cells (MSCs) is necessary for treatment.

LIPOGEMS®

LIPOGEMS® technology is used for patients that are not ready for a major surgery or can be added to surgery to optimize healing of injured tissue. Using a minimally invasive procedure to harvest the patient’s adipose tissue, LIPOGEMS® system gently cleans the tissue using only saline and micro-fragments it to an optimal size for injecting. LIPOGEMS® is FDA cleared for use in orthopaedics and arthroscopic surgery and meets the FDA guidelines for minimal manipulation and is intended for homologous use.

Benefits of orthobiologics:

  • It is a pretty simple procedure: At DMOS, we only allow licensed physicians to perform these injections, ensuring your safety. The 1 to 2 hour procedure takes place at our DMOS West clinic.
  • It is all natural: Uses bone marrow/plasma to accelerate your healing process. Because we are physician-owned, we are dedicated to choosing the best product that makes sense for your needs and offers the best value for you.
  • It is safe for your body: As the procedure uses your own platelets or bone marrow to heal it is a safe option with usually no side effects.
  • Supports long-term healing: Promotes a long-term solution, versus temporary relief from your pain (cortisone injection).
  • You will need rest and recovery: The typical recovery period is four to six weeks as your body works to heal.
  • Individualized treatment plans: Often when we are speaking about regenerative medicine, a patient is someone with a long-term chronic injury. Likely, the patient has undergone physical therapy treatments, and is exploring surgical options but is not quite ready for that next step. Many different conditions are treatable with regenerative medicine. Our physicians are trained orthopedic surgeons that are dedicated to working with you to understand your injury and your needs to ensure this is the right next step for you.
  • Minimal pain involved: The pain involved is similar to any other type of injection. On occasion, your physician may have you wear a brace or a sling for a short period. Tylenol and ice will treat any pain resulting from the injection. Prior to the injection, you will need to stop using corticosteroids or NSAID anti-inflammatory medicines, such as ibuprofen (Motrin) or naproxen (Aleve), a week before therapy.

FAQ

What types of conditions can be treated?

Currently, DMOS offers options for common shoulder, elbow, hip, knee, and wrist/hand conditions. These conditions include arthritis, ligament/tendon/muscle injuries, avascular necrosis, bursitis, labrum tears, meniscus tears, or patellofemoral syndrome/chondromalacia.

What is Platelet Rich Plasma (PRP)?

By definition, PRP is a collection of growth factors (which are proteins that are important in the healing of injuries), that can have controlled levels of white and red blood cells, based on the healing process necessary. Laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process. Many world-class athletes use PRP therapy to repair their sports injuries faster.

What is Bone Marrow Aspirate Concentrate (BMAC)?

Technically, BMAC is a collection of growth factors and cells, which include stem cells. Physicians use BMAC when they believe the potential upside of containing mesenchymal stem cells (MSCs) is necessary for treatment.

Is PRP or stem cell covered by insurance?

Orthobiologics is relatively new – even though pro athletes have had this option available for decades. Because of this, insurance companies consider regenerative medicine a new treatment option and do not cover it. These treatment options are provided at DMOS as a cash-only option.

What do I need to know about stem cells?

“Stem cells” is a term often used by the general public to describe orthobioloic injections originating from tissues thought to contain stem cells. These cells can come from your own body (autologous) or someone else (allograft). Allograft “stem cells” come from many sources including amniotic fluid, placenta or umbilical cord which is harvested at the time of birth. Allograft stem cells are available at DMOS by request only and will need to be reviewed by the physician to evaluate for safety. The “stem cells” used most commonly at DMOS come from a bone marrow aspirate (pelvis). They are believed to develop into many types of cells as well as replace and restore tissue function.

What complications have been experienced with the procedure?

Some complications which could be associated with regenerative medicine include a failed procedure, or temporary swelling and/or increased pain.

Why have a trained physician perform the injection?

At DMOS, we only allow specifically trained physicians to perform these injections, ensuring your safety. The procedures take place at any of our DMOS clinics where you will have access to other treatment options like physical therapy and surgery. Our focus is centered only around patient outcomes and satisfaction as we are not industry sponsored or biased towards a specific product line or treatment method. We also have the ability to utilize regenerative medicine in addition to a surgical procedure if recommended by your doctor.

How do you know where to place the cells?

To ensure the cells are placed in the correct location we utilize many different tools such as musculoskeletal ultrasound and real-time X-ray in addition to utilizing your prior X-rays and MRI.

When can I expect to feel better?

The results vary from patient to patient, but you will typically begin to see results 1 to 3 months after the treatment. However, some patients do not begin to see results until 6 to 9 months after treatment. We recommend a period of rest and physical therapy to many patients after their injection.

Who is a candidate for orthobiologics?

At DMOS, we commit ourselves to individualizing our treatment strategies. All options are available to DMOS patients. We are the experts in treating musculoskeletal conditions both nonoperatively and through surgery which gives us a better understanding of who is a candidate for regenerative medicine. Ideal candidates range from patients with early to moderate arthritis to an individual with a partial muscle strain/ligament injury or someone struggling with tennis/golfers elbow. There are many applicable scenarios for regenerative medicine. If you do not like the idea of surgery, ask about regenerative medicine, each provider is prepared to discuss this with their patients. After examining your medical records, your physician will determine if regenerative medicine is an option for your conditions.

How much blood do you draw?

A total of 50-200cc may be drawn (less than half a pint). Depending on your weight, a smaller amount of blood may be drawn.

Is the orthobiologic procedure painful?

The orthobiologic procedure (BMAC, PRP etc) is similar to a typical shot you receive at a doctor’s office. We recommend that you speak with your physician regarding expectations for the procedure; this may vary depending on condition and location of injection.

Is the stem cell implantation procedure painful?

The stem cell implantation procedure is similar to a typical shot you receive at a doctor’s office.

How do I prepare for my appointment?

Drink extra amounts of water prior to your appointment. Stop using corticosteroids or NSAID anti-inflammatory medicines, such as ibuprofen (Motrin) or naproxen (Aleve), a week before therapy.

Taking care of you from neck to toe

Joint, bone or ligament injuries require expert orthopedic care to guide you on the best course of treatment. Treatment may involve consultation, medication, splints, casts, physical therapy and/or surgical procedures.
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Our doctors have advanced training in their respective specialties

All of our doctors are Board Certified or Board Eligible. Additionally, our Physician Assistants and Physical & Hand Therapy teams are the best in their field which allows DMOS to be the preferred choice for comprehensive orthopedic care in central Iowa.