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While we don’t necessarily have enough evidence of all the uses of biologics to show that they are regenerating the target tissues they are injected into, when it comes to the treatment of muscle or ligament tears and tendinopathy¹, we do. There is clear evidence that a partial tear or tendinosis—cell degeneration and scar tissue healing—do show regeneration on either ultrasound or MRI scans completed at about four weeks after an injection of the biologic Platelet-Rich Plasma (PRP). Some studies have demonstrated that over 50% of the time a knee meniscal tear will show healing of the meniscus after a PRP injection into the knee joint, as demonstrated on repeat MRI scans.

In comparison, when PRP is injected into osteoarthritic joints with or without meniscal or labral tears, there is enough evidence to show improvements in patients’ symptoms, but we’re still lacking direct evidence for regrowth of cartilage lost from osteoarthritis. And so more studies like these will need to be done before we can say for certain that regeneration occurs in most cases when PRP is injected. 

Emerging evidence in some small sample size studies have shown even complete tears of ligament, including the Anterior Cruciate Ligament (ACL) and Ulnar Collateral Ligament (UCL) can be healed with an injection of the biologic Bone Marrow Aspirate Concentrate (BMAC). Obviously larger sample-sized double-blinded placebo controlled studies at large multi-centers will need to be done before we can say that these biologic studies will be able to replace the gold standard of surgical reconstruction.

Regenerative medicine holds immense potential in addressing musculoskeletal conditions. By harnessing the body's natural healing abilities, biologics can aid in tissue repair, reduce pain, and improve functionality.

1. Tendinopathy is a type of chronic overuse injury, where the tendon is repeatedly strained until tiny tears form causing degeneration.

Other Articles in the “Use of Biologics for Treatment of Musculoskeletal Conditions” Series:

• Understanding Biologics
• The Current Landscape
• The Healing Potential of Platelet-Rich Plasma
• Challenges Facing the Use of Biologics
• The Role of Exercise
• Series Summary & Takeaways

Article Series: Use of Biologics for Treatment of Musculoskeletal Conditions
From your spine and sports medicine expert Dr. Michael C. Geraci, Jr., MD PT.