We are innovators.
Who are we?
Restore Orthobiologics (ROB) started in Columbus, Ohio in 2016. The ROB co-founders with a noted perfusionist created the company to bring together the three disciplines of regenerative medicine, orthopaedics, pain medicine and blood profusion under one roof. Mr. Tom Hankins was the first individual to introduce biologic procedures to Columbus in 2001. From there, he taught and refined blood and bone marrow procedures over the next 17 years. Dr. Stephen Voto met up with Mr. Hankins in 2008. They began performing orthobiologic procedures together the next year. As the industry has grown, pain management physicians have become an important part of programs. To complete the business plan, he sought out one of the most experienced pain management physicians in Columbus, Dr. Gladstone McDowell. Together they formed ROB in 2016. The goal of the business was not to become another stem cell center. It was important to develop a more progressive approach to the emerging area of biologics. The mission of the company was to promote a safer and more academic use of blood and bone marrow products, adherent to strict regulations and principals. Equally important, was to explore safer environments to perform the procedures in the most cost-effective manner. The final goal is to drastically lower the high cost of the procedures, so more patients can have access to the emerging ortho-biological technologies.
Joint preservation techniques have been around since 1959. Orthopedists were first to use this in the treatment of arthritis. This application was first recognized in the field of regenerative medicine and has recently grown into the new specialty field of Orthobiologics.
Articular Cartilage is the tissue that covers the surfaces of our joints and is lubricated by joint fluid. It starts out smooth and shiny and allows our joints to function smoothly and glide with little friction. When articular cartilage is damaged it does not heal by itself. It does not have a blood supply to deliver stem cells and proteins for repair. Surgeons must rely on techniques to stimulate the reparative process of cartilage. Central to the reparative process is the introduction of stem cells, proteins, and platelets placed directly into a joint or disc space. Equally important, in most circumstances is the treatment of damaged or structural abnormalities in the joint or around the disc space. By combining the principles of orthopaedics and interventional pain management, we can do more for the preservation of joints and disc spaces than ever imagined.
What is Platelet-Rich Plasma (PRP)?
Platelet rich plasma or PRP is using a patient’s own blood components to create a healing response to damage tissues. By the used of advanced technology, we can concentrate platelets and white blood cells in the blood and inject the solution directly into the injured tissue or joint, stimulating a more powerful healing response. This can lead to enhance healing in a quicker more efficient way.
What is Bone Marrow Concentrate (BMC)?
Bone Marrow Aspirate Stem Cell Concentrate (BMAC) is a component of your bone marrow that contains stem cells, growth factors, and anti-inflammatory proteins which have been shown to promote bone and soft tissue healing as well as reduce symptoms of pain related to injuries, tendinitis and arthritis. Stem cells accelerate the healing of moderate to severe osteoarthritis and tendon injuries.
Who are candidates?
BMAC and PRP are recommended for patient whom have failed non-operative treatment such as physical therapy, medications, injection of steroid or viscoelastic supplementation and initial arthroscopic procedure(s). It is also an option for patients who are not a candidate for surgery or who want to avoid joint replacement surgery. The most common areas of treatment are for osteoarthritis of the hip, knee, ankle/foot, shoulder, elbow, wrist/hand and spine
What are the risks?
The use of your own BMAC and PRP is extremely safe and the procedures carry a minimal risk for complications and adverse reactions. Since it is your own blood and bone marrow there is no risk of rejection or disease transmission. The rare, and injection could potentially cause infection, bleeding, nerve damage or increased pain. All injections are performed under precision guidance into the tissue or joints by musculoskeletal ultrasound, fluoroscopy (xray) or during your surgical procedure (arthroscopy).
What is the treatment process?
Following the initial screening process and formal evaluation in the office, an individual treatment plan will be discussed with you. We will provide a complete explanation of the procedure including the risk and benefits. We will discuss the advantages and pitfalls of performing the bone marrow/PRP procedure in different clinical settings, from the office to the operating room. Our treatment approach is to only do one procedure to accomplish the needs of the patient. While many clinics offer pre and post injections of PRP, we do not normally suggest this. A follow up visit is suggested 3 to 4 weeks later either by office appointment, phone or video conference.
How much do stem cell procedures cost?
Stem cell (BMAC) and PRP procedures start at $500. The cost can increase based on where they are done and if multiple joints or discs are injected at the time of the procedure. Most centers across the county offer the same procedures starting at $5000. We are able to lower the cost based on our experience and significant cost savings measures that we have developed.
How long does it take BMC/PRP to work?
Healing response is broken up into 2 phases. The first phase lasts 4-6 weeks. Most patients have a early, positive relief of pain, primarily from the surgery. The second phase is between 3-6 months where patients get a stronger relief of the arthritic pain from the BMC/PRP.
Where is the procedure performed?
Patients have 3 options where the procedure is performed. Office, ambulatory surgical center (ASC) and traditional hospital operating room (OR). We will advise you on the location where the procedure should be done based on the degree of arthritis you have and medical safety factors that must be considered.
What happens during the procedure?
First, we withdraw blood from your arm for the processing of platelet rich plasma (PRP). That is processed first in the concentrator. The second part is the harvesting of the bone marrow. If you are awake, we place local anesthetic in your skin where we take the bone marrow, so you don’t feel the procedure. If you have it done at the time of your surgical procedure, you will not feel it since you are asleep. There are many locations where we can take the marrow from. All bones contain marrow on the inside. We then wash and sterilize the harvest area to prevent infection and drape it off to protect the spot where we remove the specimen. Next, we use a biopsy needle to safely remove the bone marrow. We transfer the marrow to the concentrator for the next procedure. The final amount of PRP/BMC depends on the concentrating system used.
Where are stem cells found in the body?
There are 3 main locations where they are found in the body, bone marrow, adipose (fat) and peripheral blood. They are also contained in cord blood, developing tooth bud of the 3rd molar and amniotic fluid (and membrane). Restore Orthobiologics only uses patient derived stem cells from their own bone marrow.
What is cartilage/joint restoration?
The newest emerging field of Orthobiologics is joint restoration. It allows the orthopedist a chance to reconstruct the defects in a joint with biological material. New techniques allow the patient to grow their own cartilage in the damaged area. There are many different options available depending on the size of the defect that needs replaced. The goal is to preserve the joint surface as long as possible to prevent joint replacement. Again, central to the success of this is use of the patient’s own stem cells and blood products.
Biocartilage matrix was introduced by Arthrex to augment microfracture procedures. It is an extremely versatile scaffold that can fill in any small defect to allow cartilage to regrow, provided that the defect has a stable outer border. It is the simplest and most cost-effective method to address small cartilage defects in a joint. It is a one stage procedure.
Cartiform is one of the newest products available for reconstruction of larger full thickness defects on the joint surface. It is a osteochondral allograph which is an intact cartilage structure that has viable chondrocytes, growth factors and proteins. It is a one stage procedure
ACI/MACI is a cartilage procedure that uses the patients own cartilage cells to grow new cartilage in a lab for re-implantation into cartilage defects. It is extremely expensive and requires 2 surgeries. The first one is to harvest fresh cartilage cells and the second to implant them back in the defect.
Osteochondral transfer is a procedure to transfer the patients own cartilage/bone or a cadaver specimen into a defect in the weightbearing area of a joint. Rather large areas of cartilage loss can be reconstructed with this technique. It is a one stage procedure.
Microfracture is the oldest of all bone marrow procedures. The basic technique involves drilling into the damaged area of cartilage to allow undiluted bone marrow to leak back into the joint. It delivers a small amount of marrow and is performed in one stage.