Best Orthobiologic treatment Chennai India, Joint, Bone, Tendon, Ligament treatment
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Orthobiologic treatment Chennai, India.
What is Orthobiologic treatment?
Orthobiologic treatments are defined as any treatment modality that harnesses the healing potential within the body’s native cells, redirecting their use for accelerated healing in damaged or diseased tissues pertaining to the musculoskeletal system. In common parlance, the term “orthobiologics” refers to a biologic product used in the orthopedic setting to augment biological healing or alter the natural course of an orthopedic disease. The biologic product may be delivered by injections or surgery.
Most orthobiologic injections are performed under image guidance, commonly with ultrasound or fluoroscopy.
However, arthroscopy and open surgery may also be utilized to provide high-definition color visualization and access for accurate cellular deployment.
Which biological substances are used ?
Hyaluronan has been around for some time now. I use this in early cases. I use minimally manipulated PRP or BMAC routinely. This is part of routine medicine and has the approval of the Govt of India.
1) Platelet rich Plasma or PRP– Platelets are a particular type of cell in your blood. They are primarily responsible for clotting of blood. They also contain proteins known as growth factors which support healing and recovery processes. Platelet rich Plasma is a filtrate of Plasma rich in platelets. In PRP, the plasma contains significantly more platelets than normal, so the concentration of growth factors can be five to 10 times higher than normal. Platelets are known to provide a diverse array of growth promoters that have the ability to work independently or with other proteins and cells to improve the healing process.
2) Medicinal signalling cells ( MSC). Medicinal signalling cells (MSC’s) were previously known as stem cells. These are non specialized progenitor cells widely present in tissues like bone marrow, umbilical cord, fat, amniotic membrane and dental pulp. These cells can stimulate the resident cells inside a joint or bone to differentiate into cartilage, ligament, meniscus and bone. They do this by an action known as ‘paracrine effect” which is basically a signal by chemical mediators (medicines) to the resident cells in a tissue, inducing them to proliferate and repair the damaged tissue. I use bone marrow concentrate. Fat and umbilical cord derived cells may be available in the future.
3) Cultured specialized cells – Chondrocytes are specialized cells present in joint cartilage. Normally these cells multiply slowly and can repair small areas of damage in young patients. In a technique known as autologous chondrocyte implantation, these chondrocytes are first harvested and multiplied in the lab. They are then placed by a surgical method over a cartilage lesion. Some of the common conditions treated by Orthobiologics are discussed below.
1) Cartilage lesion- A cartilage lesion is a localized area of damaged joint cartilage. It is the precursor of osteo-arthritis. I have treated symptomatic cartilage lesions with aurologous chondrocyte implantation, single stage cartilage regeneration with bone marrow fibrin gel. They can be also treated with scaffolds.
2) Bone conditions- Avascular necrosis can be treated with cell therapy. Fracture healing in delayed and non unions is a field for orthobiologicals
3) Bone marrow lesions occur in the subchondral area of joints. They are present in a number of conditions including osteo-arthritis. In osteo-arthritis, they are one of the main pain producing areas. Bone marrow lesions are treated by sub chondroplasty using platelet rich plasma or bone marrow concentrate.
4) Knee injuries– Sprains of the MCL, LCL, Menisci, tendons injuries are treatable.
5) Sports injuries – These involve soft tissues like ligaments, tendons, muscles, and joint structures. These have a tremendous impact on the career of sportsmen. These injuries can be treated surgically and non surgically. An example is repair of partial ACL tears. See this infogram.
6) Osteoarthritis – It is the end result of neglected injuries of the knee. It usually starts in one compartment of the knee, either the inner or outer one. Early osteo-arthritis can be treated with PRP, MSC’s and sometimes additional surgery.
7) Facet joints– These are the small joints in your back which allow you to twist and turn. Facet joint arthritis is a disabling cause of back pain in middle age. When conservative treatments have failed, biological injections can help to alleviate pain for a number of years. I offer facet joint injections with MSC’ for my knee patients who also have facet joint arthritis. I am not a spine specialist and don’t deal with back pain.
8) Hip joint- Augmentation of hip labral repair. Hip labral tears are common in India in young active individuals. This leads to hip pain and is the fore-runner of osteo-arthritis of hip. Hip labral reconstruction is a new area in which biological products like PRP and bone marrow concentrate are used.
9) Shoulder joint- Tendinosis and tendonitis of the rotator cuff, labrum, Cartilage lesions of the humeral head and glenoid are treatable with orthobiologics.
10) I treat other regions and joints like the ankle, elbow, wrist, hand, fingers with Orthobiologic injections.
Surgical Orthobiologic procedures. – These procedures are done either by key hole or open surgery. Some of the common operations are marrow stimulation, autologous chondrocyte implantation, single stage cartilage regeneration etc. Matrices and scaffolds are also used.
I also offer joint preservation procedures of the knee, hip and other joints like osteotomy, ACL reconstruction, Meniscal repair, replacement, cartilage repair, MPFL reconstruction, rotator cuff repair etc.
Let’s look at the evidence for these biological treatments.
1) Studies have shown that PRP can offer pain relief for up to nine months in early osteo-arthritis.
2) Medicinal signalling cells are more effective in advanced cases of osteo-arthritis, offering longer pain relief.
I have satisfied patients reporting pain relief for more than two years. I also have MRI evidence which demonstrates healing of bone marrow lesions.
Advantages of Orthobiological treatments–
1) They are safe.
2) They are effective.
3) A joint replacement can be postponed or avoided.
About Us ->
Which conditions are treatable by orthobiologic treatments Chennai in my practice?
Common degenerative conditions of knee, shoulder, hip, fracture non unions and soft tissue injuries can be treated with orthobiologics in Chennai, India.. Facet joints in the lower back are also treated.
How are they done?
Commonly the injection procedures are done under local anesthesia and are quite painless. I use ultrasound and/or fluoroscopic guidance. Sometimes I deliver the treatment through arthroscopic or open surgery under regional or general anesthesia as day care procedures. See how it is done here .
What are the results?
Results are encouraging in knee osteo-arthritis. Now I have patients with more than two year follow up who are pain free and functional. You can see their latest stories in the blog.
Patients have got pain relief and are able to continue with their daily activities. See this playlist for patient testimonials
Who are the right candidates for Orthobiologic treatment Chennai, India?
- Patients with mild to moderate osteo-arthritis may benefit from ortho-biologic treatment after trying other conservative measures.
- Patients not medically fit for knee replacement but still have some cartilage left. MSC’s are better with varying durability of benefit.
Who is not suited for orthobiologic treatment of knee arthritis in Chennai India?
- Obese patients with BMI > 35.
- Uncontrolled inflammatory arthritis like Rheumatoid arthritis and sero-negative arthritis. You may consult your rheumatologist for the management. For advanced cases, I offer joint replacements. See my website
- Young patients with post-traumatic arthritis and gross deformities.
- Generally associated deformities like bow legs, knock knees and shortening cannot be corrected and need corrective surgery like an osteotomy. To know more about this visit www.jointpreservationsurgery.com
Although patients with knee OA are most common, others with AVN hip, rotator cuff tears, tennis elbow, foot conditions and fracture non unions also seek help.
Dr.A.K.Venkatachalam FRCS, M.Ch Orth, DNB Orth, MS Orth is an UK board certified orthopaedic surgeon.
He pioneered microfracture of knee in Chennai in 2004 . This procedure is recognized as a first generation stem cell procedure. He has undergone training for cartilage repair in the US. He is a member of the International cartilage repair society (ICRS). He has done signaling cell & PRP procedures for hip, knee & shoulder. Our procedures are done only in Chennai after thorough clinical and radiological evaluation. These procedures are not routinely covered by insurance.
Chennai Meenakshi Multi-Specialty Hospital,
Luz church road, Mylapore, Chennai, India.
MJRC clinic- At Guest & Chennai Meenakshi multispecialty hospitals
Mobile : 9444611547
E mail : firstname.lastname@example.org
Avascular necrosis, Labral tears, Femoro - acetabular impingment (FAI), Osteoarthritis
Cartilage loss, ACL repair, Early OA, Meniscus, MCL, LCL sprains, tendonitis
Recent Blog Posts
PRP treatment Knee arthritis Chennai Dr.A.K.Venkatachalam. This elderly lady feels relieved of her knee pain after a PRP injection into her ...Read More
Autologous chondrocyte implantation India Dr.A.K.Venkatachalam. Cartilage injuries are widely prevalent in the young population in India. In this video a young ...Read More
PRP treatment Knee osteo-arthritis Chennai. An elderly Omani lady with early osteo-arthritis of her knee was relieved of knee pain. Here ...Read More
USG guided PRP injection heel pain Dr. A.K.Venkatachalam. Watch an Ultra sound guided Platelet rich Plasma injection heel pain by Dr. ...Read More
Plantar fasciitis (heel pain) Platelet rich Plasma injection India. Many many middle aged patients suffer from this painful condition. When all ...Read More
Heel pain Plantar fasciitis PRP injections Dr.A.K.Venkatachalam. Plantar fasciitis or heel pain is a common cause of disability in middle age ...Read More
Orthobiologic treatments mentioned in this website are medical techniques that may or may not be considered mainstream. As with any medical treatment, results will vary among individuals, and there is no implication that you will heal or receive the same outcome as patients herein. There could be pain or other substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.