Orthobiologics are organic and synthetic materials that help in the cure of musculo-skeletal problems and are utilized in Orthopaedic Surgery, both in and out of the surgical theater, to augment the possibilities of curing bone and soft tissue lesions. Taking into account that their effect is frequently multifactorial and, in some occasions not entirely comprehended, together with the insufficient clinical information, orthobiologics should be scrupulously assessed against other secure and clinically accepted options. The fundamental orthobiologics today ready for use in Orthopedic Surgery are the following: osseous hollow fillers, extracellular matrix (ECM) substances, platelet-rich plasma (PRP), bone morphogenetic protein-2 (BMP-2), bone marrow aspirate (BMA), bone marrow aspirate concentrate (BMAC), and mesenchymal stem cells (MSCs). It is predictable that in the time to come we will have more secure and more efficacious orthobiologics. Meanwhile, it is paramount that orthopedic surgeons have appropriate information of contemporary orthobiologics (biological adjuvants) so that they can utilize them correctly.

Platelet-rich-plasma (PRP)

PRP has provided satisfactory outcomes on bone consolidation problems. In one publication, injection of PRP into the atrophic nonunion zone of long bones led to a percentage of union of 87% at 4 months. A study comparing PRP with exchange of intramedullary (IM) nailing for long bone non unions led to a 93% binding percentage in the PRP group versus an 80% binding rate in the exchange IM nailing group. The above reports indicate the promising role that PRP appears to have in bone healing, although it is obvious that more research is needed to confirm this.

Bone marrow aspirate concentrate (BMAC)

The utilization of BMAC in osseous healing has yielded positive outcomes; in fact, it is still used in management of atrophic nonunions. Hernigou et al have published an 88% consolidation percentage in atrophic nonunions managed with percutaneous BMAC injection alone. Desai et al, using a combination of DBM and BMAC in atrophic nonunions of the tibia, found an 86% consolidation rate at 4.5 months. Even though the indications for the utilization of BMAC in the management of acute fractures are not yet well known, Schottel and Warner have used it to supplement fracture fixation while using allografts.