Biologics

Key Takeaways *  Nomenclature Shift:  BMLs are not "edema" (fluid); they are active lesions of fibrosis, microfracture, and necrosis.  *  Predictive Power:  Progressive BMLs carry a  threefold higher risk  of rapid radiographic OA onset (Moradi et al., 2024).  *  The Spine Connection:  In the vertebral column, these lesions are clinically recognized as  Modic Changes , sharing the same inflammatory pathology as knee BMLs.  *  Therapeutic Target:  Long-term data suggest subcho

Preoperative spine planning is now exacting: Pelvic incidence is measured to a degree. Instrumentation is templated to the millimeter. Yet one variable that directly impacts fusion success is still often left to intraoperative judgment: 𝗕𝗼𝗻𝗲 𝗴𝗿𝗮𝗳𝘁 𝘃𝗼𝗹𝘂𝗺𝗲. A recent study in the European Spine Journal makes a compelling case that deserves more attention. 𝗗𝗲𝗳𝗼𝗿𝗺𝗶𝘁𝘆 𝗦𝘂𝗿𝗴𝗲𝗿𝘆 𝗮𝘀 𝗮 “𝗦𝘁𝗿𝗲𝘀𝘀 𝗧𝗲𝘀𝘁” 𝗳𝗼𝗿 𝗙𝘂𝘀𝗶𝗼𝗻 𝗕𝗶𝗼𝗹𝗼𝗴𝘆 Kazarian

Every surgeon has seen it: the first 1–2 mL of aspirate is thick and cellular... and everything after that becomes progressively thinner until it looks like pure venous blood. If the marrow cavity is “full of marrow,” why does peripheral blood replace it so quickly? The answer lies in marrow structure, pressure physiology, and fluid dynamics. 𝗠𝗮𝗿𝗿𝗼𝘄 𝗦𝘁𝗿𝗼𝗺𝗮 𝗜𝘀 𝗮 𝗦𝘁𝗿𝘂𝗰𝘁𝘂𝗿𝗲, 𝗡𝗼𝘁 𝗮 𝗟𝗶𝗾𝘂𝗶𝗱 The marrow cavity is not a fluid-filled space—it’s a semi-

A new study from the Rizzoli Orthopedic Institute (Life Sciences, 2025) takes a closer look at 𝘃𝗲𝗿𝘁𝗲𝗯𝗿𝗮𝗹 𝗯𝗼𝗻𝗲 𝗺𝗮𝗿𝗿𝗼𝘄 𝗮𝘀𝗽𝗶𝗿𝗮𝘁𝗲 (𝘃𝗕𝗠𝗔) 𝗰𝗹𝗼𝘁𝘀 harvested during pedicle screw prep. While this is not a comparative trial, the findings raise several interesting possibilities for spine surgeons to consider. 𝟭. 𝗩𝗲𝗿𝘁𝗲𝗯𝗿𝗮𝗹 𝗺𝗮𝗿𝗿𝗼𝘄 𝗮𝘀 𝗮𝗻 𝘂𝗻𝗱𝗲𝗿𝘂𝘀𝗲𝗱 𝗯𝗶𝗼𝗹𝗼𝗴𝗶𝗰 𝘀𝗼𝘂𝗿𝗰𝗲 The authors harvested marrow directly from the ve

If you’ve been around orthobiologics, you’ve heard of 𝗜𝗥𝗔𝗣 — 𝗜𝗻𝘁𝗲𝗿𝗹𝗲𝘂𝗸𝗶𝗻-𝟭 𝗥𝗲𝗰𝗲𝗽𝘁𝗼𝗿 𝗔𝗻𝘁𝗮𝗴𝗼𝗻𝗶𝘀𝘁 𝗣𝗿𝗼𝘁𝗲𝗶𝗻. Its job: block 𝗜𝗟-𝟭, the cytokine that drives joint inflammation and cartilage loss. When IL-1 is blocked by 𝗜𝗟-𝟭𝗥𝗮, inflammation cools — often dramatically. 𝗪𝗵𝗲𝗿𝗲 𝗜𝘁 𝗦𝘁𝗮𝗿𝘁𝗲𝗱 In the early 2000s, 𝗗𝗿. 𝗣𝗲𝘁𝗲𝗿 𝗪𝗲𝗵𝗹𝗶𝗻𝗴 (Germany) discovered that incubating blood with treated glass beads triggered white ce

𝗧𝗵𝗲 𝗲𝘃𝗶𝗱𝗲𝗻𝗰𝗲 𝘀𝘂𝗴𝗴𝗲𝘀𝘁𝘀 𝗣𝗥𝗣 𝗮𝗻𝗱 𝗕𝗠𝗔𝗖 𝗱𝗼𝗻’𝘁 𝗿𝗲𝗴𝗿𝗼𝘄 𝗰𝗮𝗿𝘁𝗶𝗹𝗮𝗴𝗲, 𝘀𝗼 𝘄𝗵𝘆 𝗱𝗼 𝗽𝗮𝘁𝗶𝗲𝗻𝘁𝘀 𝘁𝗵𝗶𝗻𝗸 𝘁𝗵𝗲𝘆 𝘄𝗶𝗹𝗹? There’s no question PRP and BMAC can deliver value. Studies consistently show pain relief, improved function, and in some cases slowing of degeneration. For the right patient, those gains matter. But here’s the problem: patients hear “𝘀𝘁𝗲𝗺 𝗰𝗲𝗹𝗹𝘀” or “𝗴𝗿𝗼𝘄𝘁𝗵 𝗳𝗮𝗰𝘁𝗼𝗿𝘀” and expect regenerat

The Hidden Risks Physicians Face With “Stem Cell” Therapies in Florida and Utah Thanks to #𝗰𝗵𝗿𝗶𝘀𝘁𝗼𝗽𝗵𝗲𝗿𝗰𝗲𝗻𝘁𝗲𝗻𝗼  for pushing me to revisit assumptions about physician liability as it relates to states' "stem cell" laws. A deeper look suggests that even with state laws permitting certain stem cell procedures, the risks remain high. Here’s the uncomfortable truth: 𝘀𝘁𝗮𝘁𝗲 𝗽𝗲𝗿𝗺𝗶𝘀𝘀𝗶𝗼𝗻 ≠ 𝗹𝗲𝗴𝗮𝗹 𝗽𝗿𝗼𝘁𝗲𝗰𝘁𝗶𝗼𝗻. Physicians remain exposed on mul

For decades, every biology textbook drilled into us that mitochondria are the “powerhouse of the cell.” But a new Scientific American piece argues that’s misleading—and maybe even harmful to our understanding. ( https://lnkd.in/gnN3CB_t ) Think about it this way: 𝘈 𝘱𝘰𝘸𝘦𝘳𝘩𝘰𝘶𝘴𝘦 𝘫𝘶𝘴𝘵 𝘨𝘦𝘯𝘦𝘳𝘢𝘵𝘦𝘴 𝘦𝘯𝘦𝘳𝘨𝘺. 𝘈 𝗺𝗼𝘁𝗵𝗲𝗿𝗯𝗼𝗮𝗿𝗱, 𝘣𝘺 𝘤𝘰𝘯𝘵𝘳𝘢𝘴𝘵, 𝘪𝘯𝘵𝘦𝘨𝘳𝘢𝘵𝘦𝘴 𝘢𝘯𝘥 𝘥𝘪𝘳𝘦𝘤𝘵𝘴 𝘤𝘰𝘶𝘯𝘵𝘭𝘦𝘴𝘴 𝘴𝘪𝘨𝘯𝘢𝘭𝘴 𝘢𝘵 𝘰𝘯𝘤𝘦. The arti

PRP seems to dominate conversations on LinkedIn. It’s familiar, accessible, and widely used in orthopedic practices. But this recent...

In the dynamic world of spinal fusion surgery,  Bone Marrow Aspirate (BMA)  stands as a foundational therapy. For years, the prevailing...

If you're in the tissue or medical device space, the term   "objective intent"   isn't just regulatory jargon — it's the lens through...

FDA Shifts from Inspections to Instagram: New Warning Letters Signal Evolving Enforcement Strategy Recent FDA warning letters to two...