Orthobiologics in the operating room—who, what, where, when, and how

Orthobiologic agents, such as platelet-rich plasma, concentrated bone marrow aspirate, cell-based therapies, amniotic suspension allografts, and adipose tissue, among others, have shown promising clinical results in many areas of sports medicine. Researchers and surgeons alike are excited about the potential of these orthobiologic materials to provide isolated growth factors, naturally derived blood components, and autologous tissue in an effort to improve healing potential following office procedures or as an adjunct to surgery. In the surgical setting, orthobiologics are currently used during meniscal repair, anterior cruciate ligament reconstruction, rotator cuff repair, and procedures addressing cartilage defects. This chapter will describe the current techniques and evidence for common orthobiologic agents used as an adjunct to procedures in the operating room.