Office-Based Orthobiologic Procedures for Tendons

There has been a growing interest in the use of office-based orthobiologics, which are defined as the use of biological tissues to optimize musculoskeletal/orthopedic injuries, for treatment of tendons for four reasons. First, the emergence of the musculoskeletal (MSK) ultrasound for diagnosis and evaluation of tendons allows improved procedural outcomes by offering higher accuracy and less pain than palpation-guided injections. Second, the field has seen a significant increase in research and understanding of tendinopathy, and we understand that there are several growth factors that are important for tendon healing. Third, our veterinary and oral surgical colleagues utilizing orthobiologics with animal models have demonstrated promising outcomes. Finally, there is a growing body of evidence demonstrating short-term relief from corticosteroid injections, but poor long-term outcomes with potential tendon degeneration and rupture. Thus, other injection alternatives such as platelet-rich plasma, bone marrow aspirate concentration, adipose tissue, and amniotic tissue are being sought.