Biologics News

NEW YORK — Results presented at the American Shoulder and Elbow Surgeons Annual Meeting showed improved tendon quality at 1 year among patients who received bone marrow aspirate concentrate injection at the time of rotator cuff repair.

The answer to the question is “yes and no.” Orthobiologics are adjuvants that are thought to improve the endogenous healing potential of the injured skeletal element. Although orthopedic implants and surgical techniques have improved significantly over the last few decades, we still encounter fractures that, despite all efforts, fail to unite. These are the situations where orthobiologics will make a difference. Unfortunately, at this stage, we are unable to predict at the time of the index surgery who will unite and who will end up with a nonunion. In addition, we can often only guess whether a growth factor is needed, a fracture site is lacking skeletal stem cells or the stem cells are less osteogenic due to an underlying medical condition. Once we are able to identify the fracture that will require augmentation with a biologic, such as bone marrow aspirate concentrate, platelet-rich plasma or others, then we will be able to recommend meaningful use of orthobiologics for primary trauma cases. Until then, the use will be limited to patients in which the past medical history or clinical appearance of the injured limb suggest suboptimal healing potential. While this is not a wrong approach per se, it will lead to overuse of these costly products.


Some factors related to the patient or surgery, including inadequate blood flow and fracture stability, can result in fracture nonunion. However, literature shows most of these traumatic fractures promptly heal after surgical treatment. For those that do not, sources told Orthopedics Today the use of orthobiologics may provide a needed boost in healing.

Patients with rheumatoid arthritis who achieve low disease activity with tofacitinib plus methotrexate can safely withdraw methotrexate without fear of worsening disease activity, according to findings published in The Lancet Rheumatology.

Adalimumab, with or without methotrexate, is well-tolerated over a period of at least 7 years among most children with polyarticular-course juvenile idiopathic arthritis, according to data published Arthritis Care & Research.

The FDA has given its fast track designation to the investigational cell therapy IDCT for the treatment of degenerative disc disease.

Registry data from four European countries found no association between treatment with TNF inhibitors for psoriatic arthritis and an overall increase in cancer risk, according to findings presented at the EULAR Annual Congress.

The promise of stem cell therapy is attractive. Through relatively simple and minimally invasive methods, physicians can harvest pluripotent cells from patients, place the cells in the damaged or degenerative area and presumably the cells will modify and stimulate a healing response that regenerates tissue that looks and behaves like normal tissue. The cells can be harvested without compromising the donor area, separated from the non-stem cell environment and rapidly concentrated with special readily available machines, delivering a potentially powerful catalyst to fix abnormal tissue. Most stem cell treatments involve a patient’s own cells. Therefore, the risk of disease transmission, rejection or allergic reaction can be greater minimized.

Ixekizumab was associated with superior efficacy outcomes compared to adalimumab in a cohort of DMARD-naive patients with active psoriatic arthritis, according to findings presented at the EULAR Annual Congress.

Patients with moderate-to-severe rheumatoid arthritis who switch from etanercept to the biosimilar etanercept-szzs experienced no impacts on drug efficacy, safety or immunogenicity, according to data published in Arthritis Research & Therapy.