Degenerative musculoskeletal disorders are one of the top causes of pain and disability in the adult population and non-healing sports injuries the main cause of early termination of sporting careers. The demand for musculoskeletal tissue regeneration has led to an alternative approach referred to as orthobiologics, which is based on cellular and molecular components capable of promoting tissue repair.
The increasing role of regenerative medicine in Musculoskeletal Disorders can be attributed to one simple fact - Not all musculoskeletal injuries get better with physiotherapy/rest /medicines alone and not all require surgery. The use of analgesics or pain relieving gels delivers short term results but do not address or alter the etiological source of pain and disability. The aim is to heal the cause or source of pain(mostly chronic injuries in musculoskeletal system) and not treat the pain alone.
The prerequisite for initiating the healing response/regeneration is inciting a fresh injury in a chronically injured tendon/ligament /muscle or even articular cartilage (Subchondral bone microfracture and cartilage needling is possible under ultrasound guidance or c arm guidance at many sites in cases of focal chondral defects).
Once the initial reinjury is caused under imaging guidance, these regenerative interventions aim to create a conducive microenvironment for tissue repair. By modulating the local inflammatory response and promoting angiogenesis, regenerative interventions create an environment that supports tissue regeneration. Regenerative interventions like PRP/GFC involve the delivery of growth factors to the injured site to promote cellular migration, proliferation, and extracellular matrix synthesis. Growth factors enhance tissue healing by stimulating the recruitment of reparative cells and encouraging tissue remodelling with formation of healthy type I collagen tissue. All regenerative interventions should be done under imaging guidance with ultrasound being the most commonly used imaging modality to guide these regenerative interventions. C-arm guidance is used to guide regenerative interventions to spinal structures like intervertebral discs, facet joints and sacroiliac joints.