Application of Orthobiologics in Achilles Tendinopathy: A Review
Luciano C. Ramires,
Madhan Jeyaraman,
Sathish Muthu,
Navaladi Shankar A,
Gabriel Silva Santos,
Lucas Furtado da Fonseca,
José Fábio Lana,
Ramya Lakshmi Rajendran,
Prakash Gangadaran,
Manasi P. Jogalekar,
Alfredo A. Cardoso,
Alex Eickhoff
Affiliations
Luciano C. Ramires
Department of Orthopaedics and Sports Medicine, Centro Clínico Mãe de Deus, Porto Alegre 90110-270, Brazil
Madhan Jeyaraman
Department of Orthopaedics, Faculty of Medicine—Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600095, India
Sathish Muthu
Department of Orthopaedics, Government Medical College and Hospital, Dindigul 624304, India
Navaladi Shankar A
Department of Orthopaedics, Apollo Hospitals, Greams Road, Chennai 600006, India
Gabriel Silva Santos
Department of Orthopaedics, The Bone and Cartilage Institute, Indaiatuba 13334-170, Brazil
Lucas Furtado da Fonseca
Department of Orthopaedics, The Bone and Cartilage Institute, Indaiatuba 13334-170, Brazil
José Fábio Lana
Department of Orthopaedics, The Bone and Cartilage Institute, Indaiatuba 13334-170, Brazil
Ramya Lakshmi Rajendran
Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
Prakash Gangadaran
Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea
Manasi P. Jogalekar
Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA 94158, USA
Alfredo A. Cardoso
Department of Oncology-Integrative Medicine-Pain Care, IAC—Instituto Ana Cardoso de Práticas Integrativas e Medicina Regenerative, Gramado 95670-000, Brazil
Alex Eickhoff
Department of Orthopaedics, Centro Ortopédico Eickhoff, Três de Maio 98910-000, Brazil
Orthobiologics are biological materials that are intended for the regeneration of bone, cartilage, and soft tissues. In this review, we discuss the application of orthobiologics in Achilles tendinopathy, more specifically. We explain the concepts and definitions of each orthobiologic and the literature regarding its use in tendon disorders. The biological potential of these materials can be harnessed and administered into injured tissues, particularly in areas where standard healing is disrupted, a typical feature of Achilles tendinopathy. These products contain a wide variety of cell populations, cytokines, and growth factors, which have been shown to modulate many other cells at local and distal sites in the body. Collectively, they can shift the state of escalated inflammation and degeneration to reestablish tissue homeostasis. The typical features of Achilles tendinopathy are failed healing responses, persistent inflammation, and predominant catabolic reactions. Therefore, the application of orthobiologic tools represents a viable solution, considering their demonstrated efficacy, safety, and relatively easy manipulation. Perhaps a synergistic approach regarding the combination of these orthobiologics may promote more significant clinical outcomes rather than individual application. Although numerous optimistic results have been registered in the literature, additional studies and clinical trials are still highly desired to further illuminate the clinical utility and efficacy of these therapeutic strategies in the management of tendinopathies.
