Biologic agents are a normal constituent of peripheral blood. These agents play a fundamental role in the healing of a wound and in the process of regeneration in the human body. In addition, these components promote the formation of small capillary vessels, improve the healing of the soft tissues and enhance the regeneration of the tissues.
The everyday role of these agents in our body comes into play whenever an injury occurs, whether major or minor. In such a case there is always bleeding, of greater or lesser degree. With that bleeding these agents are released from the peripheral blood, their purpose being to set the healing process in motion immediately. Even in a superficial minor injury to our skin, the wound that results contains such agents, which speed up its healing.
The aim of treatment with these agents is to collect them from the peripheral blood and to create a concentration of such agents that is 5 to 10 times greater than that found in our blood. The high concentration of these agents in a small volume of fluid creates an enormous potential for healing.
Besides the normal growth factors, biologic agents naturally contain other substances known as proteins and cytokines. These components contribute to the regeneration of the tissues in several ways: by reducing inflammation, by improving cell growth and by providing signalling to the body's immune system. Certain types of substance known as cytokines also focus on creating metabolic pathways that support cellular recovery. In addition, this process can have a considerable effect in reducing pain.
A simple way of understanding what these agents contribute is to compare them to the fertiliser we often use on plants. Fertiliser is not a structural component, but it contains substances that enhance the regenerative process in plants and promote their growth.
The procedure for using biologic agents is straightforward and can be carried out in the consulting room. Blood is taken from the patient's arm (in the same way as a routine sample for blood tests) and this blood is then placed in a special device called a centrifuge. In that device a small fraction of the blood collected is isolated, one that is rich in growth factors. This fraction is then administered by injection into the area of interest.
In recent years these agents have been used in cases of early arthritis of the knee or the hip and of other joints, tendinitis, muscle strains, plantar fasciitis (heel spur) and many other orthopaedic conditions.
In cases of the knee and the hip where cartilage or other lesions are found during arthroscopy, the injection of biologic agents can then be given at the end of the operation as an adjunctive treatment.
The published data of recent years show encouraging early results from the use of these agents.