ORTHObiologics
Firstly, Orthobiologics injections utilise the body’s own healing mechanisms. In addition, They are used to heal damaged soft tissues – ligaments, tendons, muscles, nerves and joints – that are not responding to conventional measures.
What is involved with orthobiologics?
At Cheltenham Podiatry, our podiatrists are trained in Orthobiologics. This is a growing field of regenerative medicine utilising proteins, cytokines, and other molecular structures from the body to allow the body to heal itself. Our podiatrists are trained by leading international experts, ensuring safe, sterile and effective technique. Additionally, Injections are delivered via precise ultrasound guidance.
Orthobiologics include platelet rich plasma, platelet lysates and protein concentrates (IRAP, A2M, exosomes) separated from the blood, that are adjusted to suite patient factors, the affected tissue, and then injected via ultrasound guidance to speed healing, reduce pain and improve function. Evidence is mounting for their superiority to other forms of injectants as cortisone, and for longer lasting pain relief (eg osteoarthritis, plantar fasciitis) and faster recovery. Particularly important in high performing sports individuals that require quicker return to activity. Recent evidence points to high concentrates being more effective for many conditions, that is platelet nos from 2 billion to 12 billion or more in a single injection. To ensure dosages match latest evidence, we are one of the 1st providers to have a high end sysmex blood analyser on site, for instant confirmation of the correct platelet dosage, and appropriate white blood cell mix.
Treatment may require one or several injection sessions over several weeks or months. For arthritic joints, ligament and tendon tears, Orthobiologics involves injecting the damaged area and associated anatomy, treating the affected tissue as an organ, this involves the joint, ligaments and often nerves. Thus, a more rounded approach. Often combined with biomechanical correction, and on occasions with prolotherapy and perineural injection therapy to improve joint integrity and calm local inflamed nerves.
We commonly also treat plantar fascia tears, ankle pain and sprains, achilles tears, peroneal tendon tears, and many other foot and leg conditions. There is developing evidence that it slows cartilage damage in arthritic joints.
WHAT CONDITIONS CAN ORTHOBIOLOGICS HELP WITH?
Orthobiologics can treat common conditions when other more conservative measures fail. Ligaments, tendons, muscles, nerves and joints. They can be used to delay joint replacements, or rather if a joint replacement is not suitable for an individual. They are delivered via ultrasound guided injections to ensure accuracy of placement. Conditions treated include:
- arthritic joints
- nerve entrapments
- Achilles Tendon conditions
- Acute and chronic Ankle injuries
- Sports injuries
- Plantar Fasciitis
- Talar dome lesions, cartilage defects
- Tendon and ligament tears, commonly plantar fascia partial tears, achilles and peroneal tendon partial tears.
- Plantar plate tears
- Ankle ligament tears due to a sprain
Recent Papers
- Baltzer, A. W., Moser, C., Jansen, S. A., & Krauspe, R. (2009). Autologous conditioned serum (Orthokine) is an effective treatment for knee osteoarthritis. Osteoarthritis and cartilage, 17(2), 152–160. https://doi.org/10.1016/j.joca.2008.06.014
- Bansal, H., Leon, J., Pont, J.L. et al. Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Sci Rep 11, 3971 (2021). https://doi.org/10.1038/s41598-021-83025-2
- Everts, P. A., Lana, J. F., Onishi, K., Buford, D., Peng, J., Mahmood, A., Fonseca, L. F., et al. (2023) Angiogenesis and Tissue Repair Depend on Platelet Dosing and Bioformulation Strategies Following Orthobiological Platelet-Rich Plasma Procedures: A Narrative Review. Biomedicines, 11(7), 1922. MDPI AG. Retrieved from http://dx.doi.org/10.3390/biomedicines11071922
- Johnson DS, Dhiman N, Badhal S, Wadhwa R. Effects of Intra-articular Platelet Rich Plasma on Cartilage Thickness, Clinical and Functional Outcomes in Knee Osteoarthritis. Cureus. 2022;14(12):e32256. Published 2022 Dec 6. doi:10.7759/cureus.32256
- Monto R. R. (2014). Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot & ankle international, 35(4), 313–318. https://doi.org/10.1177/1071100713519778
- Raeissadat, S. A., Ghorbani, E., Sanei Taheri, M., Soleimani, R., Rayegani, S. M., Babaee, M., & Payami, S. (2020). MRI Changes After Platelet Rich Plasma Injection in Knee Osteoarthritis (Randomized Clinical Trial). Journal of pain research, 13, 65–73. https://doi.org/10.2147/JPR.S204788
- Riboh, J. C., Saltzman, B. M., Yanke, A. B., Fortier, L., & Cole, B. J. (2016). Effect of Leukocyte Concentration on the Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis. The American journal of sports medicine, 44(3), 792–800. https://doi.org/10.1177/036354651558078
- Sekiya, I., Katano, H., Mizuno, M., Endo, K., Asami, A., Kajiwara, M., Otomo, N., Koga, H., Masumoto, J., & Ozeki, N. (2025). 3D-MRI analysis of cartilage thickness changes after PRP injection in medial knee osteoarthritis: A preliminary report. PloS one, 20(4), e0321067. https://doi.org/10.1371/journal.pone.0321067
- Von Wehren, L., Pokorny, K., Blanke, F., Sailer, J., & Majewski, M. (2019). Injection with autologous conditioned serum has better clinical results than eccentric training for chronic Achilles tendinopathy. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(9), 2744–2753. https://doi.org/10.1007/s00167-019-05465-8
Book an appointment
ARE ORTHOBIOLOGICS RIGHT FOR YOU?
Firstly, To find out if Orthobiologic treatments are right for you, speak to the team at Cheltenham Podiatry. Additionally, We are committed to helping you with the best treatments for you.
Moreover,Book an appointment using our online form, or call our team today on 03 9583 3093. Alternatively, you can contact us using our form below.
Platelet Rich Plasma:
Platelet Rich Plasma (PRP) can aid in the repair of damaged tendons, ligaments , and other podiatric conditions which fail standard care . it can also be helpful in reducing pain and inflammation from osteoarthritis.
After an injury, the platelets in our blood are activated, releasing growth factors that help to heal damaged tissues. PRP involves blood collection, 60- 120 ml is required for high platelet nos (similar to pathology for blood tests), which is then processed in sterile conditions to separate and concentrate the platelets and filter for suitable white blood cell parameters. The resulting platelet rich plasma is then injected into the site of injury.
Additionally, Generally, 1 injection is usually required .
Furthermore, While many PRP setups only allow for a ‘one size fits all’ treatment, our clinic is able to engineer the appropriate concentrations of the essential blood products for the needs of individual patients and their condition. Often at least 2-12 billion platelets are achieved per injection and white blood cell requirements can be customised for the condition.
Moreover, variations on PRP , include protein concentrates, A2M, IRAP, exosomes and Platelet Rich Fibrin. Protein concentrate is powerful anti inflammatory product, while Platelet Rich Fibrin is used often as a scaffold – or can be used as an application designed to accelerate wound healing, making it particularly useful for difficult diabetic/ischaemic wounds/ulcers. It can also be used to fill spaces and encourage healing in boney fractures etc.
Conditioned Serum (Cytokine Concentrate):
This treatment is similar to PRP, with the difference being that it concentrates specific anti-inflammatory proteins that play a pivotal role in conditions such as osteoarthritis.
Today, with much research underway, the biological causes of osteoarthritis are much better understood. We now know it is not just mechanical cartilage wear but a complex disease that affects the entire joint.
Moreover, Destructive and aggressive messenger proteins play a pivotal role in the development of osteoarthritis, and Conditioned Serum treatment addresses this directly.
Patients who suffer from osteoarthritis and are not surgical candidates, or have not responded to other treatments such as physiotherapy, are excellent candidates for this treatment.
Similarly, patients who would prefer not to have joint replacement surgery can benefit greatly, with pain reduction and improvement in function.
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