Orthobiologics are biologic injections, most often prepared from your own blood, bone marrow or fat, used for joint, tendon and ligament pain. They fall into two families: blood-based platelet-rich plasma (PRP), and tissue- or cell-based products such as bone marrow aspirate (BMA) and fat-derived microfragmented adipose tissue (MFAT). PRP has far more randomized trials behind it and improved knee arthritis pain and function over placebo. Bone marrow and fat matched PRP in head-to-head knee trials but did not clearly beat it. Against hyaluronic acid, a 2026 network meta-analysis found the gains were not clinically meaningful. In Boulder, Aneesh Garg, DO, CAQ places every PRP and stem cell injection himself under live ultrasound.
You searched one word that covers several different treatments, and the clinic you choose decides which one you get and how well it is placed. This page sorts what each orthobiologic is, where the trials say it helps and where they say it does not, so you can walk into any clinic on the Front Range knowing what to ask.
Each orthobiologic, and what the trials found
PRP: concentrated platelets from your own blood
PRP is your blood, spun so the platelets and the growth factors they carry are concentrated, then injected into the injured tendon, ligament or joint. In knee arthritis, a 2024 network meta-analysis of 48 randomized trials and 9,338 knees found PRP improved pain and function compared with placebo at a minimum of six months. PRP had the highest ranking in that analysis, in which bone marrow concentrate made up 2.5% of the injections studied; a 2026 network meta-analysis ranked fat-derived and bone marrow products above PRP against hyaluronic acid, though no orthobiologic gain exceeded the minimal clinically important difference. A 2024 ESSKA consensus regarded PRP as a possible first-line injectable for knee arthritis grades 1 to 3. A 2026 Arthroscopy commentary put it plainly: PRP is not a single intervention. That is why not all PRP is the same.
Bone marrow in the trials: matched PRP, did not beat it
BMA is marrow drawn from your pelvis and concentrated at the same visit. In a 90-patient randomized trial in knee arthritis grades 1 to 3, a single injection of bone marrow concentrate and a single injection of PRP both improved pain and function, and the two performed similarly out to 24 months (about 28% of participants were lost to follow-up by 24 months, more in the PRP group); bone marrow was not superior. In a 480-patient randomized phase 3 trial in Nature Medicine, none of three cell injections (bone marrow concentrate, fat-derived stromal cells or donor umbilical cord cells) was superior to a cortisone injection at one year. A 2026 review of 21 randomized trials found bone marrow products were associated with improvements in pain and function, but superiority over comparators was inconsistent and depended on the clinical condition.
Fat-derived cells: MFAT, harvested the same day
MFAT, microfragmented adipose tissue, is fat harvested from you and injected at the same visit. In a 118-patient randomized trial, a single injection of MFAT and a single injection of PRP both gave clinically significant improvement up to 24 months, and MFAT was not superior to PRP. Across cell sources the picture is more cautious: a 2025 Cochrane review concluded stem cell injections may slightly improve knee pain and function compared with placebo, on low-certainty evidence, and a 2024 meta-analysis of 16 trials of mesenchymal stem cells against placebo or usual care concluded they probably provide little to no improvement in pain or physical function. A 2025 European consensus placed cell-based therapy as a second-line injectable. Which source fits which joint is covered in MFAT versus BMA.
What a search for orthobiologics near me should find
From Boulder, Longmont, Louisville, Lafayette, Broomfield or Erie, distance is the easy filter. The harder one is four questions: who places the injection and whether live ultrasound guides it, what platelet specification the protocol is designed to, who the clinic turns away, and how results are followed. Our answers are built into Dynamic PRP+ and Dynamic Stem Cell+, set out above. The proceedings of a 2022 AAOS-Biologic Association symposium describe the evidence for many biologic agents as sparse and of low quality. Here, patients’ self-reported results are followed in practice, and separately we run IRB-approved retrospective studies via Rocky Vista University, inside the DART Lab, our research and training program. Products sold as stem cells in a vial are a separate question, answered in is it really stem cell therapy.
Who is a candidate, and who is not
Here is where an orthobiologic has randomized support, and two cases where it should not be the plan.
- Knee arthritis, where pooled randomized trials found PRP improved pain and function over placebo, and a 2024 ESSKA consensus regarded PRP as a possible first-line injectable for grades 1 to 3
- Rotator cuff tendinopathy, where one randomized trial favored three plasma-rich-in-growth-factors injections over cortisone, and supraspinatus tears, where a 51-patient randomized crossover trial favored bone marrow concentrate plus platelet products over home exercise
- Not PRP for ankle arthritis or chronic Achilles tendinopathy, where randomized trials found it no better than placebo
- Not when a meniscus tear locks or catches, or follows clear trauma: those are considered for surgery first
Before you book, ask
- Will the physician place my injection under live ultrasound?
- What platelet specification is your PRP protocol designed to, and which cell source would you choose for me and why?
- Who would you turn away, and how do you follow results after treatment?
Why it matters
Nobody searches orthobiologics for fun. You are looking for a way back to the trail, the ski day or the floor with the grandkids, without losing months to an operation. The right orthobiologic, placed precisely, is time bought back. The wrong one, or the right one in the wrong place, is time lost.
Frequently asked questions
What are orthobiologics?
Orthobiologics are biologic injections, most often prepared from your own blood, bone marrow or fat, used for joint, tendon and ligament pain. A 2025 review of evidence-based guidelines groups them as blood-based, such as platelet-rich plasma (PRP), or tissue- and cell-based, such as bone marrow aspirate (BMA) and microfragmented adipose tissue (MFAT). PRP comes from your blood, BMA from bone marrow in your pelvis and MFAT from your own fat. Some come from a donor: a 480-patient trial tested donor umbilical cord cells beside bone marrow and fat-derived cells. The orthobiologics we use are made from you. A 2026 AAPM&R guidance statement describes PRP as an orthobiologic intervention and notes that orthobiologic therapies remain an evolving area of practice.
Where can I get orthobiologics near Boulder?
Dynamic Athlete is at 1790 30th St, Suite 270, Boulder, CO 80301, and the clinic serves Boulder, Louisville, Lafayette, Erie, Broomfield, Longmont, and the surrounding Front Range. Aneesh Garg, DO, CAQ places every PRP and stem cell injection himself under live ultrasound. A new patient appointment is 90 minutes. A Dynamic PRP+ injection appointment takes about 90 minutes, and a Dynamic Stem Cell+ procedure takes 2 to 3 hours. Wherever you go, ask who places the injection, what platelet specification the PRP protocol is designed to, who the clinic turns away, and how results are followed.
Can osteoarthritis be treated with biologics?
Yes, with honest limits. For knee arthritis grades 1 to 3, a 2024 ESSKA consensus regarded PRP as a possible first-line injectable, and a 2025 ESSKA consensus placed cell-based therapy as a second-line injectable. A 2024 network meta-analysis of 48 randomized trials found PRP improved pain and function over placebo. The gains are modest: a 2026 network meta-analysis of 24 trials and 2,960 patients found orthobiologic improvements over hyaluronic acid did not exceed the minimal clinically important difference up to 12 months, and a 480-patient trial found no cell injection superior to cortisone at one year. For ankle arthritis, a randomized trial found PRP no better than saline.
Is hyaluronic acid an orthobiologic?
Hyaluronic acid (HA) is a gel injection made outside your body, and the trials in this post use it as the comparator rather than as an orthobiologic. A 2025 systematic review found HA has the largest evidence, followed by PRP. In a 2024 network meta-analysis of 48 randomized trials, HA and PRP both improved knee pain over placebo, and PRP ranked higher. A 2026 commentary framed PRP’s small advantage over HA as symptom modification rather than cartilage regeneration. We do offer HA, paired with PRP rather than as a stand-alone plan.
Are orthobiologics the same as stem cell therapy?
Not exactly. Stem cell therapy is one kind of orthobiologic, and ours uses bone marrow or fat harvested from you at the same visit. PRP is also an orthobiologic but contains platelets, not stem cells. A vial product, such as amniotic fluid, umbilical cord or exosome preparations, is a different category. FDA’s consumer page lists amniotic fluid, Wharton’s jelly, umbilical cord blood and exosome products among unapproved regenerative products. On evidence, a 2025 Cochrane review found stem cell injections may slightly improve knee pain and function compared with placebo, on low-certainty evidence, so expectations should be set honestly.
Do orthobiologics rebuild cartilage?
The trials do not show that reliably. A 2026 meta-analysis of 28 randomized trials of stem cell-based therapies found no consistent structural benefit on MRI, and a 2026 network meta-analysis called radiologic signs of cartilage repair across orthobiologics inconsistent. The 2025 Cochrane review remained uncertain of the effect of stem cell injections on structural progression in the knee. The realistic goal is less pain and better function, so you can keep moving, not a new joint surface.
How many orthobiologic injections will I need, and how long do results last?
There is no fixed number; the plan comes from the exam. Trials have tested both: in a 90-patient randomized trial, a single injection of bone marrow concentrate or of PRP improved knee pain and function out to 24 months, while a rotator cuff trial used three platelet injections every other week. On duration, a 2024 ESSKA consensus found PRP provides a longer effect than the short-term effect of cortisone injections, and in a 118-patient trial, single injections of MFAT or PRP improved knee scores up to 24 months. Results vary by tissue and by person, and patients’ self-reported results are followed in practice.
How much do orthobiologics cost, and does insurance cover them?
We give a quote after a thorough evaluation. We price the plan for optimal outcomes, not line items off a menu. Medicare and Kaiser are accepted for consultations and office visits only; PRP, BMA and MFAT are out of pocket. Treatment is HSA and FSA eligible, and Cherry financing is available. The value is in the time you get back: fewer months sidelined and a plan built for your tissue, not a menu item.
Stop guessing which biologic. Start getting your time back.
Every month spent on the wrong treatment is a month you do not get back. Book the 90-minute evaluation with Aneesh Garg, DO, CAQ: he examines the problem, reviews your imaging and tells you which orthobiologic fits, if any, so you stop losing months to the wrong one.
Book an Evaluation
1790 30th Street Suite 270 · Boulder, CO 80301 · 303-997-1733